糖尿病基础上的脓毒症模型

摘要: 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。

Sepsis Model based on the Diabetes

Abstract: Objective To observe the effect of diabetes mellitus ( DM) on the septic inflammation． Method Diabetic rat model was induced by high glucose and high fat diet and streptozotocin( STZ) injection． On this basis，the sepsis model by the cecal ligation and puncture ( CLP) ． Then the heart tissue and whole blood specimens were harvested and inflammatory factor TNF-α was assayed by ELISA，neutrophil percentage was calculated，and observe the heart tissue was stained by periodic acid-Schiff stain ( PAS) ． Ｒesult ( 1) Compared with normal rats，diabetic rats typically emerged polyuria，polydipsia，polyphagia，and weight loss，with a significant rise in blood glucose and weight loss ( P ＜ 0. 001) ． PAS stain showed myocardial cells staining in normal-control rats，without interstitial cells and blood vessels staining，but cardiomyocytes and interstitial microvessels in diabetic rats all stained． ( 2) In sepsis model based on the diabetes，after CLP the rats showed abnormal activities and mental state; in normal-CLP rats serum TNF-α values were significantly higher than those in normal-control rats ( P ＜ 0. 01) and apparently higher than normal-sham rats ( P ＜ 0. 05) ． In DM-control rats serum TNF-α values were significantly higher than those in normal-control rats ( P ＜ 0. 01) and apparently higher than those in DM-CLP rats ( P ＜ 0. 05) ; In normal-CLP rats peripheral blood neutrophil percentage was significantly higher than those in normal-control and normal-sham rats ( P ＜ 0. 01) ，and in DM-CLP rats peripheral blood neutrophil percentage significantly higher than those in DM-Control and DM-Sham( P ＜ 0. 01) ． Conclusion Inflammatory response of normal rats and DM rats to sepsis is different． This may be related to the difference of immune status in normal and DM rats．