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目的观察糖尿病(DM)对脓毒症炎症反应的影响。方法高糖高脂饮食喂养联合链脲佐菌素(STZ)制备糖尿病大鼠模型,在此基础上通过盲肠结扎穿孔术(CLP)建立脓毒症模型。留取心脏组织和全血标本,ELISA检测炎症因子TNF-α,中性粒细胞百分比计数,观察心脏组织糖原染色。结果 (1)糖尿病模型:与正常大鼠相比,糖尿病大鼠出现多饮、多食、多尿、体质量减轻的典型“三多一少”症状,血糖和体质量显著升高(P<0.001);心肌糖原染色结果显示:正常大鼠心肌细胞核染色,间质细胞及血管无染色;糖尿病大鼠心肌细胞和心肌微血管均染色且血管壁增厚,血管周围细胞核明显深染。(2)糖尿病基础上的脓毒症模型,造模后大鼠出现异常的行为活动和精神状态;Normal-CLP组血清TNF-α值显著高于Normal-Control组(P<0.01),明显高于Normal-Sham组(P<0.05)。DM-CLP组血清TNF-α值显著高于DM-Control组(P<0.01),明显高于DM-Sham组(P<0.05);Normal-CLP组外周血中性粒细胞百分比显著高于Normal-Control组和Normal-Sham组(P<0.01),DM-CLP组外周血中性粒细胞百分比显著高于DM-Control组和DM-Sham组(P<0.01)。结论正常大鼠和DM大鼠对脓毒症的炎症反应是不一致的,这可能与正常大鼠和DM大鼠体内免疫状态相关。
Objective To observe the effect of diabetes mellitus (DM) on inflammatory response in sepsis. Methods Diabetic rats were induced by high-sucrose and high-fat diet combined with streptozotocin (STZ), and sepsis model was established by cecal ligation and puncture (CLP). Cardiac tissues and whole blood samples were collected, and the inflammatory cytokines TNF-α and neutrophil percentage were counted by ELISA. Cardiac glycogen staining was observed. Results (1) Diabetic model: Compared with the normal rats, diabetic rats showed symptoms of “three more and one less”, more blood sugar and body weight than those of normal rats P <0.001). Myocardial glycogen staining showed that the nuclei of normal rat myocardial cells were stained, interstitial cells and blood vessels were not stained. Myocardial cells and myocardial microvessels of diabetic rats were stained and the vessel wall was thickened. (2) Diabetes-based sepsis model showed abnormal behavioral activity and mental state in model rats. The serum TNF-α level in Normal-CLP group was significantly higher than that in Normal-Control group (P <0.01) In Normal-Sham group (P <0.05). The serum TNF-α in DM-CLP group was significantly higher than that in DM-Control group (P <0.01), and significantly higher than that in DM-Sham group (P <0.05). The percentage of neutrophil in Normal-CLP group was significantly higher than that in Normal group -Control group and Normal-Sham group (P <0.01). The percentage of neutrophils in DM-CLP group was significantly higher than that in DM-Control group and DM-Sham group (P <0.01). Conclusion The inflammatory response to sepsis in normal rats and DM rats is inconsistent, which may be related to the immune status in normal rats and DM rats.