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目的:肠道内的消化酶在MODS发生发展过程中起着关键的作用,有研究发现非结合型胆红素可以灭活胰蛋白酶和糜蛋白酶。基于非结合型胆红素对消化酶的灭活作用,本研究主要探讨非结合型胆红素含量丰富的天然牛黄对多器官功能障碍综合症大鼠的保护作用。方法:通过腹腔注射无菌石蜡酵母多糖混悬液的方法制作MODS大鼠模型。观察天然牛黄对MODS大鼠的生理状态,生命体征,血气分析,多指标系列生化检测,二胺氧化酶水平,以及心肺肝肾重要脏器病理组织学检查的变化及影响。结果:天然牛黄治疗组大鼠生命体征,血气分析结果,生化指标,血清DAO水平与MODS模型组比较,体温、心率、呼吸检测结果显著降低;pH、PaO2、SO2、AB、BE值升高,PaCO2值降低;LDH、ALT、Cr值减少;DAO水平降低,均有显著差异(P<0.05),且心肺肝肾等组织病理变化也有明显改善。结论:天然牛黄能明显恢复石蜡酵母多糖混悬液造模方法引起的MODS大鼠生理状态,生命体征,能有效改善MODS大鼠脏器功能及病理形态,对MODS大鼠具有脏器保护作用。其机制可能是非结合型胆红素灭活消化酶所致,待进一步研究。
OBJECTIVE: Intestinal digestive enzymes play a key role in the development of MODS. Studies have found that non-conjugated bilirubin can inactivate trypsin and chymotrypsin. Based on the inactivation of digestive enzymes by unconjugated bilirubin, this study mainly explores the protective effect of natural bezoar with abundant non-binding bilirubin on multiple organ dysfunction syndrome rats. Methods: MODS rat model was made by intraperitoneal injection of sterile paraffin-embedded polysaccharide suspension. To observe the changes and effects of natural bezoar on physiological status, vital signs, blood gas analysis, multi-index series biochemical tests, diamine oxidase levels and pathological examination of vital organs of heart, lung and kidney in MODS rats. Results: The vital signs, blood gas analysis results, biochemical indexes and serum DAO levels in the natural bezoar treatment group were significantly lower than those in the MODS model group. The results of temperature, heart rate and respiration were significantly decreased. The values of pH, PaO2, SO2, AB, PaCO2 value decreased; LDH, ALT, Cr decreased; DAO levels decreased, both were significantly different (P <0.05), and pathological changes of heart and lung liver and kidney tissue has also been significantly improved. CONCLUSION: Natural Bezoar could restore the physiological status and vital signs of MODS rats induced by the model of paraffin yeast polysaccharide suspension. It can effectively improve the organ function and pathological changes of MODS rats and has the protective effect on MODS rats. The mechanism may be non-conjugated bilirubin inactivated digestive enzymes due to be further studied.