新生猪多器官功能障碍综合征模型建立的实验研究

Establishment of a neonatal piglet model of multiple organ dysfunction syndrome

摘要:

目的：探讨采用盲肠结扎加穿孔(CLP)建立新生猪多器官功能障碍综合征(MODS)模型的方法及实验与临床意义。方法：选用健康长白新生猪14只,随机分成实验组(E组,n=9)和对照组(C组,n=5),实验组施行盲肠结扎加穿孔(CLP)制成MODS动物模型,对照组只行剖腹和盲肠探查术。动态观察两组血清生化指标(ALT,AST,ALB,BUN,Cr,CKMB,lac)及血小板、血气分析(PaO2,PaCO2)的变化,通过光镜观察动物各重要生命器官组织形态学变化。结果：与对照组相比,实验组动物在CLP后血ALT,AST,BUN,Cr,CKMB,lac24h即已开始升高,48～96h明显升高,48h时ALT为83.0±9.3U/L、AST为348.8±132.9U/L、BUN为10.5±2.5mmol/L、Cr为79.2±9.0μmol/L、CKMB为5152.0±1857.8U/L、lac为12.3±4.0mmol/L(P<0.01),96h后开始有所降低,但仍高于0h;ALB24h后开始降低,各时间点均低于对照组,但差异无显著性;血小板24h开始降低,96h与0h比较差异有显著性;PaO2和PaCO248h时实验组与对照组差异有非常显著性(P<0.01);实验组动物死亡率与对照组差异有显著性(P<0.05),MODS的发生率为56%。实验组动物肺、肝、心、肾、胃肠道等器官均有不同程度的病理改变。结论：CLP诱发了新生猪多个器官的功能障碍,该实验可用于新生动物MODS模型的探讨。

Abstract:

OBJECTIVE: To study the reliability of establishing a neonatal piglet model of multiple organ dysfunction syndrome (MODS) by cecal ligation and puncture (CLP). METHODS: Fourteen neonatal piglets were randomly assigned into Experiment group (n=9) and Control group (n=5). MODS model was established in the piglets from the Experiment group by CLP.The Control group underwent a sham-operation. Serum biochemical parameters(ALT, AST, ALB, BUN, Cr, CK-MB and lactic acid), blood platelet counting and blood gas analysis(PaO-2 and PaCO-2) were tested at 0, 24, 48, 72, 96, and 120 hrs after operation. The histomorphological changes of important vital organs were examined by hematoxylin-eosin staining under a light microscope. RESULTS: The levels of serum ALT, AST, BUN, Cr, CK-MB and lactic acid in the Experiment group began to increase 24 hrs after operation. Significant differences were observed between the Experiment and the Control group at 48 hrs in ALT(83.0±9.3 U/L vs 57.8±15.8 U/L), AST(348.8±132.9 U/L vs 106.4±12.5 U/L) , BUN(10.5±2.5 μmol/L vs 4.3 ±1.0 μmol/L), Cr(79.2±9.0 μmol/L vs 53.6±6.8 μmol/L), CK-MB(5 152.0±1 857.8 U/L vs 1 243.0±354.5 U/L), and lactic acid(12.3±4.0 mmol/L vs 4.6±1.5 mmol/L)(P<0.01). The high levels of the above parameters persisted until 96 hrs after operation in the Experiment group and then decreased but were still higher than those at 0 h after operation. After operation, the blood platelet counting decreased significantly at 96 hrs, and PaO-2 decrease and PaCO-2 increase were observed at 48 hrs in the Experiment group compared with the Control group. All animals, except one, in the Experiment group died within 120 hrs after operation (with the MODS incidence of 56%), while none died in the Control group. The tissue injuries with different degrees were observed in the lungs, liver, heart, kidneys and gastrointestinal tracts of the Experiment group. CONCLUSIONS: Neonatal piglet MODS model can be established successfully by CLP.