低分子肝素钙联合曲美他嗪对大鼠急性肠系膜上静脉血栓的治疗效果

发布时间：2018-04-26 07:10

本文选题：急性周围型肠系膜上静脉血栓 + 透壁性肠梗死　；参考：《华北理工大学》2016年硕士论文

【摘要】：目的研究低分子肝素钙(LHC)联合曲美他嗪(Trimetazidine)对大鼠急性肠系膜上静脉血栓的治疗作用,并对其作用机制进行初步探讨。方法1.实验动物及分组:160只250g-300g SD雄性大鼠,随机分成4组,低分子肝素钙+曲美他嗪组(LT组)、低分子肝素钙组(L组)、曲美他嗪组(T组)、生理盐水对照组(N组),每组40只。结扎小肠内侧缘8cm区域内的肠系膜静脉一级静脉分支及两端静脉弓,制作大鼠绞窄性周围型急性肠系膜上静脉血栓(AMVT)模型。2.各实验组的药物干预:1)N组:造模成功后即刻从大鼠尾静脉静脉注射生理盐水(0.2ml/100g/次),每间隔12h重复注射一次,至术后72h。2)L组:造模成功后即刻从尾静脉注射曲美他嗪注射液(10mg/kg/次),每间隔12h重复注射一次,至术后72h。3)T组:造模成功后即刻皮下注射LHC(30U/100g/次),每间隔12h重复注射一次,至术后72h。4)LT组:造模成功后即刻皮下注射LHC(30U/100g/次),每间隔12h重复注射一次,至造模后72h,同时即刻从尾静脉注射曲美他嗪注射液(10mg/kg/次),每12h重复注射一次,至术后72h。3.术后6h、12h、24h、48h、72h再次开腹,观察腹腔大体改变;切取肠道组织标本行HE染色,并对肠道组织损伤进行评分;ELISA法测不同时间段各组肠道组织ATP含量水平;抽取下腔静脉血离心后用ELISA法测不同时间段各组血清中MDA、CK含量。4.统计学方法:计量数据资料采用以均数±标准差(?χ±s)来表示,组间均数的比较用单因素方差分析,组间均数多重比较最小显著差法检验;使用SPSS21.0数据统计软件进行统计学分析,以P0.05,差异具有统计学意义。结果1术后大鼠一般情况:N组:大鼠术后饮食,3只大鼠36h后死亡,腹腔肠管粘连成团,大量血性腹水。T组:大鼠术后饮食,1只大鼠36h后死亡,部分肠管粘连扭曲。L组:大鼠术后腹部无膨隆,均无死亡。LT组:大鼠术后饮食后腹部无膨隆,肠道无粘连,无死亡。2肠道病理学损伤评分L组、LT组、T组均低于N组,LT低于L组、T组,L组低于T组,各组间差异均有统计学意义(P0.05);肠道组织匀浆液中ATP含量L组、LT组、T组均高于N组,LT高于L组、T组,L组高于T组,各组间差异均有统计学意义(P0.05);血清MDA、CK含量L组、LT组、T组均低于N组,LT低于L组、T组,L组低于T组,各组间差异有统计学意义(P0.05)。结论1曲美他嗪可能通过改善肠道平滑肌代谢,从而预防肠梗死的作用。2低分子肝素钙可能通过改善肠道微循环来减少MVT肠损害。3低分子肝素钙联合曲美他嗪对MVT治疗起协同作用,推测可预防肠道透壁性肠梗坏死。
[Abstract]:Objective to study the therapeutic effect of low molecular weight heparin (LHC) combined with trimetazidine on acute superior mesenteric venous thrombosis in rats and its mechanism. Method 1. Experimental animals and 160 male 250g-300g SD rats were randomly divided into 4 groups: low molecular weight heparin calcium trimetazidine group (LT), low molecular weight heparin calcium group (L group), trimetazidine group (T group), normal saline control group (n group), 40 rats in each group. To establish a rat model of acute superior mesenteric vein thrombosis (SAVT) by ligating the branch of mesenteric vein and the venous arch at both ends of the mesenteric vein in the 8cm region of the medial margin of the small intestine, the rat model of acute superior mesenteric vein thrombosis was established. Drug intervention of each experimental group 1: n group: immediately after the establishment of the model, the rats were injected with normal saline 0.2ml / 100g / time from the tail vein of rats, and the rats were injected repeatedly every 12 hours. To postoperative 72h.2)L group, 10 mg / kg trimetazidine injection was injected immediately after successful modeling, and was repeated every 12 hours. In 72h.3)T group, LHC(30U/100g/ was injected subcutaneously immediately after modeling, and every 12 hours. To the 72h.4)LT group, LHC(30U/100g/ was injected subcutaneously immediately after the model was established, and repeated injection every 12 hours, then 72 hours after the model was made. At the same time, trimetazidine injection was injected immediately from tail vein to 10 mg / kg / kg, every 12 hours, until 72 h 路3 after operation. The abdominal cavities were observed at 6h, 12h, 24h, 48h and 72h after operation, and the intestinal tissue samples were removed for HE staining, and the ATP content in the intestinal tissue was measured by Elisa at different time points. After centrifugation of inferior vena cava blood, the content of MDA-CK in serum of each group was measured by ELISA method. Statistical method: the metrological data were expressed as mean 卤standard deviation? 蠂卤s. The comparison of mean among groups was tested by single factor analysis of variance, the least significant difference between groups was tested by multiple comparison of mean among groups, and the statistical analysis was carried out by SPSS21.0 statistical software. With P0.05, the difference was statistically significant. Results 1 the general situation of rats in group N: 3 rats died after operation, 3 rats died after operation, and 3 rats died after operation. Group L: no abdominal distension, no death, no abdominal distension, no intestinal adhesion, no abdominal distension, no intestinal adhesion, no abdominal distension, no intestinal adhesion, no abdominal distension, no intestinal adhesion, no abdominal distension, no intestinal adhesion, no abdominal distension and no intestinal adhesion. No death .2 intestinal pathological injury score in group L was lower than that in group N, LT was lower than that in group L, and that in group L was lower than that in group T, and that in group L was lower than that in group T. The content of ATP in intestinal tissue homogenate of group L was higher than that of group N, and that of group L was higher than that of group L. The levels of MDA-CK in serum of group L were lower than those of group N, and that of group L was lower than that of group L, and the difference between groups was statistically significant (P 0.05). Conclusion 1 trimetazidine may improve the metabolism of intestinal smooth muscle. The effect of low molecular weight heparin calcium may reduce MVT intestinal damage by improving intestinal microcirculation. 3 low molecular weight heparin calcium combined with trimetazidine may play a synergistic role in the treatment of MVT. It is suggested that LMWH can prevent intestinal transmural intestinal infarction necrosis.
【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R572.3

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