【摘要】 目的:探讨胰岛素控制不同目标血糖水平对脓毒症大鼠肿瘤坏死因子(TNF-α)、内皮细胞特异性分子(ESM-1)表达的影响以及对肺损伤的作用。方法:40只SD大鼠随机分为5组:假手术组(Sham组)、脓毒症组及血糖控制A组(4.4~6.1 mmol/L)、B组(6.2-8.3 mmol/L)、C组(8.4-10.0 mmol/L),各8只。盲肠结扎穿孔术后12 h处死,双抗夹心ELISA法检测血清TNF-α、ESM-1水平,光镜观察肺组织病理切片。结果:脓毒症组血清TNF-α、ESM-1的表达明显高于Sham组及各血糖控制组(均P<0.05)。A组较B组和C组TNF-α、ESM-1的表达明显降低(均P<0.05);B组低于C组(P<0.05)。肺病理组织损伤评分脓毒症组均明显高于sham组及各控制组(均P<0.05),A组较B组和C组明显降低(均P<0.05)。结论:与6.2~8.3 mmol/L及8.4~10.0 mmol/L比较,血糖控制在4.4~6.1 mmol/L明显降低血中TNF-α、ESM-1的表达,且对脓毒症大鼠肺损伤保护作用最明显。更多还原

【Abstract】 Objective: To explore the effect of target glucose control therapy on the expression of tumor necrosis factor-α( TNF-α) and endothelial cell specific molecule-1( ESM-1) and its effect on lung injury for rats with sepsis. Methods: Forty Sprague-Dawley rats were randomly divided into five groups: sham operation group( sham group),sepsis group( group CLP),glycemic control A group( 4. 4 ~6. 1 mmol/L),glycemic control B group( 6. 2 ~8. 3 mmol/L) and glycemic control C group( 8. 4 ~ 10. 0 mmol / L),eight rats for each group. The sepsis model of rat was established by cecal ligation and puncture( CLP),and the models were sacrificed 12 hours after CLP. Serum levels of TNF-α and ESM-1 were detected by enzyme-linked immunosorbent assay( ELISA),the pathological changes of lung tissue was observed by optical microscope. Results: The expressions of TNF-α and ESM-1 in sepsis groups were higher than those in sham group and all glycemic control groups( P < 0. 05). They were significantly decreased in group A than those in group B and C( P < 0. 05),and they were lower in group B than those in group C( P < 0. 05). The pathology tissue injury score was significantly higher in sepsis group than those in sham group and all glycemic control groups( P < 0. 05),and the lung pathology tissue injury score was significantly lower in group A( P < 0. 05). Conclusion: Compared with glycemic control B group and C group,target glucose control management at 4. 6 ~ 6. 1 mmol / L can reduce the levls of TNF-α and ESM-1,and could significantly alleviate acute lung injury.更多还原