急性腸系膜缺血模型的制作與實(shí)驗(yàn)研究及缺血修飾蛋白對腸缺血臨床診斷的初步探討
[Abstract]:Background: early diagnosis of acute mesenteric ischemia is difficult and the rate of death and disability is very high. The incidence of disease has been increasing in recent years. Basic research on AMI is mostly done on animal models based on vascular ligation. The model of artery ligation can only simulate the extreme case of AMI. Acute superior mesenteric venous thrombosis is more different than that of venous ligation. The research model can not represent the pathophysiological process of clinical pathogenesis, which inevitably leads to the deviation of the research results. There have been more reports of laser-induced stenosis or occlusion of blood vessels. In this experiment, the acute mesenteric vessel stenosis was induced by direct laser irradiation to mesenteric vessels, and the model of acute mesenteric ischemia was obtained, and the changes of serological markers in the model were observed. Materials and methods: different laser parameters were used to irradiate the arteries and veins of the free mesenteric arteries and veins of the experimental rats, and to suture the closed abdomen for observation. After 24 hours, the rats were observed again, and compared with the animals with mesenteric arteriovenous ligation, and the results were compared with those of the animals with mesenteric arteriovenous ligation. To explore the laser parameters leading to acute mesenteric ischemia. After finding out the ideal laser parameters, 66 SD rats were randomly divided into 11 groups (6 rats in each group). Group A _ 2T _ 1 irradiated artery; The blood and intestinal specimens were collected 1 hour after irradiation in A1V1 group, and those in A2V2 group were retained at 2 hours after irradiation. Urokinase was injected into caudal vein within 15 minutes after irradiation in T _ 1T _ 2 group, blood and intestinal specimens were collected at 2 hours, and blood samples of superior mesenteric vein were collected at 1 hour and 2 hours after irradiation in P _ 1 / P _ 2 group. Results: rat models of acute mesenteric ischemia injury could be induced by direct irradiation of mesenteric vessels with appropriate laser parameters, and different laser parameters could lead to different degrees of intestinal ischemia. In the model, serum D dimer tended to increase, but there was no statistical difference compared with the control group. The level of D dimer in blood of systemic circulation and portal vein was similar, but there was no statistical difference. The content of intestinal fatty acid binding protein increased significantly at 2 hours after irradiation of artery or vein, which was significantly different from that of control group. Thrombolytic therapy had no protective effect on the serological indexes and pathological manifestations of the model group. The positive rate of ischemia modified albumin was 100 in 10 cases of mesenteric ischemia. Ischemic modified proteins were significantly higher in patients with mesenteric ischemia than in patients with acute myocardial infarction. Conclusion: the rat model of acute mesenteric ischemia can be established by direct laser irradiation. The serum D dimer level is increased in acute mesenteric ischemia, but there is no statistical difference, and the concentration of D dimer in blood samples of systemic circulation is consistent with that of portal vein blood. Intestinal fatty acid binding protein increased significantly at 2 hours, suggesting that it is of significance in the diagnosis of acute mesenteric ischemia. Ischemic modified protein did not change in animal model, but the positive rate was high in clinical cases.
【學(xué)位授予單位】:中國人民解放軍醫(yī)學(xué)院
【學(xué)位級別】:博士
【學(xué)位授予年份】:2014
【分類號】:R572.3
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