高压氧辅助抗蛇毒血清治疗对五步蛇中毒大鼠肾保护作用研究

发布时间：2018-06-01 21:58

本文选题：HBO + 抗蛇毒血清　；参考：《遵义医学院》2017年硕士论文

【摘要】：目的:通过五步蛇毒中毒大鼠模型,观察五步蛇毒中毒后肾组织的病理变化过程,并探讨HBO辅助抗蛇毒血清治疗对五步蛇毒中毒大鼠肾的保护作用。方法:将96只健康成年雄性SD大鼠随机分为空白对照组、蛇毒中毒组、血清治疗组、血清+HBO治疗组,每组24只。经尾静脉注射五步蛇蛇毒建立中毒模型,血清治疗组于建模成功后即从尾静脉注射抗蛇毒血清,血清+HBO治疗组于注射抗蛇毒血清后0 h、4 h、11 h、23 h予以HBO治疗一次,空白对照组不予任何处理。各组部分大鼠于注毒后1 h、5 h、12 h、24 h经腹主动脉采血用于检测凝血功能、肾功能、血清MDA和SOD,另部分大鼠用生理盐水及多聚甲醛经左心室灌注固定肾组织,并取右肾组织行HE染色观察病理变化。结果:(1)中毒后大鼠的表现:中毒大鼠出现烦躁、竖毛、活动及进食水减少、皮肤内脏出血、血尿等,肾脏肉眼观察有明显充血。(2)肾组织病理改变:蛇毒中毒大鼠出现肾小球出血、肾小囊扩张,周围毛细血管存在不同程度的充血,肾小管管腔扩张,可见细胞低平,刷状缘脱落,肾小管上皮细胞空泡化,肾间质组织炎性细胞浸润。随着时间的推移肾出血减少,炎性细胞浸润增加。以上病变在抗蛇毒血清治疗后显著改善,在血清+HBO治疗后1h、5h改善较单纯蛇毒血清治疗明显。(3)肾功能结果:与空白对照组比较,蛇毒中毒组各时间点的血Cr显著升高(P0.05)。与蛇毒中毒组比较血清治疗组、血清+HBO治疗组在1 h血Cr值显著降低(P0.05),其中血清+HBO治疗组血Cr值明显低于血清治疗组(P0.05)。(4)凝血功能结果:与空白对照组比较,蛇毒中毒组各时间点的APTT、PT显著升高(P0.05)。与蛇毒中毒组比较,血清治疗组、血清+HBO治疗组APTT值均明显降低。在注毒1h、5h血清+HBO治疗组APTT值又明显低于血清治疗组(P0.05)。PT值血清治疗组、血清+HBO治疗组各时间点比较无差异(P0.05)。与空白对照组比较,蛇毒中毒组FIB于注毒后1 h明显降低(P0.05),予以血清、血清+HBO治疗后明显上调,但血清治疗组、血清+HBO治疗组两组间无差异。(5)血清MDA、SOD结果:蛇毒中毒组各时间点MDA值显著高于空白对照组(P0.05)。血清治疗组各时间点MDA值较蛇毒中毒组下降(P0.05),血清+HBO治疗组较单纯血清治疗组1 h、5h下降(P0.05)。血清治疗组SOD值1 h、5 h较蛇毒中毒组明显上调(P0.05),血清+HBO治疗组各时间点较蛇毒中毒组明显上调(P0.05),血清+HBO治疗组1h较血清治疗组明显上调(P0.05)。结论:(1)五步蛇毒中毒可导致大鼠肾损伤。(2)HBO辅助抗蛇毒血清治疗对五步蛇中毒大鼠肾损伤有保护作用,越早采用其保护效应越佳。
[Abstract]:Objective: to observe the pathological changes of renal tissue in rats with serpentine venom poisoning and to explore the protective effect of HBO on the kidney of rats poisoned by APV venom. Methods: 96 healthy male Sprague-Dawley rats were randomly divided into control group, snake venom poisoning group, serum treatment group and serum HBO treatment group with 24 rats in each group. The poisoning model was established by injecting snake venom into the tail vein. The serum treated group was injected with antivenom serum from the tail vein immediately after the model was successfully established, and the serum HBO group was treated with HBO once at 0 h after injection of antivenom serum for 11 h and 23 h after the injection of antivenom serum. Blank control group was not treated. Blood samples were collected from abdominal aorta at 1 h, 5 h, 12 h and 24 h after injection to detect coagulation function, renal function, serum MDA and SOD, while some rats were perfused with normal saline and polyformaldehyde to fix renal tissue through left ventricle. The pathological changes of the right kidney were observed by HE staining. Results the manifestations of rats after poisoning: irritability, bristling, decreased activity and feeding water, skin and visceral hemorrhage, hematuria, etc. The pathological changes of renal tissue were as follows: glomerular hemorrhage, renal capsule dilatation, peripheral capillary congestion, tubule dilatation, low level cells and brush edge abscission were observed in rats with snake venom poisoning. Tubular epithelial cells vacuolated and interstitial inflammatory cells infiltrated. Over time, renal bleeding decreased and inflammatory cell infiltration increased. The above pathological changes were significantly improved after antivenom serum treatment, and the renal function was significantly improved at 1 hour after serum HBO treatment than that by serovenom treatment alone. Results: compared with the blank control group, the serum Cr of snake venom poisoning group was significantly higher than that of the control group at each time point (P 0.05). Compared with snake venom poisoning group, serum HBO treatment group significantly decreased serum Cr value at 1 h, and serum HBO treatment group had lower serum Cr value than serum-treated group (P0.05P0.05U. 4) coagulation function: compared with blank control group, serum HBO treatment group had significantly lower blood Cr value than that of blank control group. APTTT in snake venom poisoning group was significantly higher than that in control group (P 0.05). Compared with snake venom poisoning group, the APTT value of serum treatment group and serum HBO group were significantly decreased. The value of APTT in the serum HBO treatment group was significantly lower than that in the serum treatment group at 1 hour or 5 h after injection of toxin, and the serum HBO value in the serum treatment group was significantly lower than that in the serum treatment group. There was no difference between the serum HBO treatment group and the serum HBO treatment group at different time points (P 0.05). Compared with the blank control group, the FIB in the snake venom poisoning group decreased significantly at 1 hour after the injection of the drug. The serum and serum HBO were significantly up-regulated, but in the serum treatment group, there was no significant difference between the two groups. There was no difference between the two groups in serum HBO. The results of serum MDA-SOD: the MDA value of snake venom poisoning group was significantly higher than that of the blank control group at each time point (P 0.05). The MDA value of serum treatment group was lower than that of snake venom poisoning group at each time point (P0.05A), and the serum HBO group was lower than that of serum-treated group (1 h, 5h). Compared with snake venom poisoning group, the SOD value of serum treatment group was significantly higher than that of snake venom poisoning group for 1 h, the serum HBO group was significantly higher than that of snake venom poisoning group at each time point, and the serum HBO treatment group was significantly up-regulated P0.05N at 1 hour compared with serum treatment group. Conclusion (1) Viper venom poisoning can induce renal injury in rats. HBO combined with anti-snake venom serum therapy has protective effect on renal injury of rats. The earlier it is used, the better the protective effect is.
【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R646

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