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目的:探讨降钙素原(Procalcitonin,PCT)及C反应蛋白(C-reactive protein,CRP)在急性肠梗阻大鼠血清中的水平及其临床意义。方法:将83只Wistar大鼠分为对照组(n=13)、假手术组(n=35)和急性肠梗阻组(n=35)。对照组大鼠采集标本后处死,肠梗阻组行开腹手术结扎回肠末端,假手术组仅行开腹手术。检测8 h、24 h、48 h、72 h及96 h血清PCT及CRP水平,观察急性肠梗阻大鼠回肠组织的病理学改变情况。结果:假手术组PCT与CRP水平在术后24 h内显著升高,48 h至96 h逐渐下降;各时间点PCT水平明显高于对照组,而CRP水平在实验结束时已恢复至正常水平。肠梗阻组PCT和CRP水平在各时间点均明显高于对照组,并逐渐增加,到实验结束时达到高峰;肠梗阻组PCT和CRP水平在48 h-96 h均显著高于假手术组,差异具有统计学意义(P<0.05)。组织病理学检查显示,对照组大鼠肠壁粘膜结构正常,假手术组可见轻度病理改变,肠梗阻组大鼠回肠组织可见粘膜结构明显破坏,绒毛坏死,严重水肿和炎症细胞浸润。结论:血浆PCT和CRP水平能够反映肠梗阻的状态和肠粘膜受损程度。
Objective: To investigate the serum levels of procalcitonin (PCT) and C-reactive protein (CRP) in acute intestinal obstruction rats and its clinical significance. Methods: 83 Wistar rats were divided into control group (n = 13), sham operation group (n = 35) and acute intestinal obstruction group (n = 35). The control group rats were sacrificed after the specimens were collected, the intestinal obstruction group underwent laparotomy to ligate the terminal ileum, and the sham-operated group underwent laparotomy only. The serum PCT and CRP levels at 8 h, 24 h, 48 h, 72 h and 96 h were measured to observe the pathological changes of ileal tissue in rats with acute intestinal obstruction. Results: The levels of PCT and CRP in sham-operation group increased significantly within 24 h after operation and decreased gradually from 48 h to 96 h. The PCT level at each time point was significantly higher than that in control group, while CRP level returned to normal level at the end of the experiment . The levels of PCT and CRP in intestinal obstruction group were significantly higher than those in control group at each time point, and gradually increased to the peak at the end of the experiment. PCT and CRP levels in intestinal obstruction group were significantly higher than those in sham operation group at 48 h-96 h, The difference was statistically significant (P <0.05). Histopathological examination showed that the structure of mucosa in the intestinal wall of the control group was normal, mild pathological changes were observed in the sham operation group, mucosal structure was significantly damaged, villus necrosis, severe edema and infiltration of inflammatory cells in the ileum of the intestinal obstruction group. Conclusions: Plasma PCT and CRP levels can reflect the state of intestinal obstruction and the extent of intestinal mucosal damage.