摘要
目的 通过超声心动图探讨脓毒症老年大鼠早期心脏功能的变化。方法 采用盲肠结扎穿孔法建立脓毒症老年大鼠模型,造模成功的大鼠随机分为手术1 h组,手术3 h组,每组6只,另设立假手术组与对照组,每组6只。分别检测每组大鼠超声心动图、心肌酶[包括肌酸激酶同工酶(CK-MB)、肌酸激酶(CK)、肌钙蛋白I(TNI)及乳酸脱氢酶(LDH)]、血清炎症因子[包括转化生长因子β(TGF-β)、白细胞介素1β(IL-1β)、白细胞介素6 (IL-6)、白细胞介素8 (IL-8)、白细胞介素10 (IL-10)及肿瘤坏死因子α(TNF-α)]。结果 在手术1 h组,部分炎症因子包括TNF-α、TGF-β、IL-10已经开始升高,其中TNF-α、IL-10较正常对照组与假手术组均有统计学意义(P<0.05),TGF-β较正常对照组有统计学意义(P<0.05)。手术3 h组,大部分炎症因子包括TNF-α、TGF-β、IL-10、IL-1β、IL-8较正常对照组与假手术组均升高(P<0.05),其中手术3 h组IL-8较手术1 h组也升高(P<0.05)。手术1 h组的心脏超声功能指标较对照组与假手术组变化差异无统计学意义。手术3 h组部分心脏超声指标有变化:左心室射血分数(LVEF)和左心室缩短率(LVFS)较对照组、假手术组、手术1 h组降低。左心室收缩末期内径(LVEDs)与收缩末期容积(ESV)较对照组、假手术组、手术1 h组扩大。手术1 h组和3 h组的心肌酶TNI、CK、CK-MB、LDH与正常对照组和假手术组的差异均无统计学意义。结论 脓毒症老年大鼠早期(3 h内)已经出现明显的炎症反应,伴有心脏功能障碍,早期心脏功能障碍主要表现为左心室收缩功能减弱,左心室收缩末期内径和容积扩大,而左心室舒张末期内径与容积无明显变化。此时心肌损伤酶并没有发生明显的变化。
Objective To investigate the early changes of cardiac function in septic elderly rats by echocardiography.Methods The sepsis model of elderly rats was established by cecal ligation and perforation.The sepsis model rats were randomly divided into 1-hour operation group and 3-hour operation group,with 6 ones in each group.In addition,a sham operation group and a control group were established,with 6 rats in each group.Echocardiogram,myocardial enzymes [including creatine kinase isoenzyme(CK-MB),creatine kinase(CK),troponin I(TnI) and lactate dehydrogenase(LDH)],serum inflammatory factors [including transforming growth factor beta(TGF-β),interleukin 1 beta(IL-1β),interleukin 6(IL-6),interleukin 8(IL-8),interleukin 10(IL-10) and tumor necrosis factor alpha(TNF-α)] of each group were detected,respectively.Results In the 1-hour operation group,some inflammatory factors including TNF-α,TGF-β and IL-10 had begun to increase,and the levels of TNF-α and IL-10 were significantly higher than those of the control group and the sham operation group(P<0.05),TGF-β was statistically different from that of the control group(P<0.05).In the 3-hour operation group,the levels of most inflammatory factors included TNF-α,TGF-β,IL-10,IL-1β,IL-8 were higher than those of the control group and the sham operation group(P<0.05),and IL-8 of the 3-hour operation group was higher than that of the 1-hour operation group(P<0.05).There were no significant differences in the cardiac ultrasound function indexes among the 1-hour operation group,the control group and the sham operation group.Some cardiac ultrasonic indexes changed in the 3-hour operation group:left ventricular ejection fraction(LVEF) and left ventricular shortening rate(LVFS) were lower than those of the control group,sham operation group and 1-hour operation group;left ventricular end-systolic diameter(LVEDs) and end-systolic volume(ESV) were larger than those of the control group,sham operation group and 1-hour operation group.There was no significant difference in myocardial enzymes(TnI,CK,CK-MB,LDH) among the four groups.Conclusion In the early stage(within 3 hours) of sepsis,the elderly rats have obvious inflammatory reaction,accompanied by cardiac dysfunction.The early cardiac dysfunction is mainly manifested by the weakening of left ventricular systolic function(the expansion of left ventricular end systolic diameter and volume),while the left ventricular end-diastolic diameter and volume have no significant changes.At this time,there was no significant change in myocardial enzymes.
作者
莫为春
陈俊峰
郭朋
赵鑫
王苛苛
杨斐宇
申捷
张志华
Mo Weichun;Chen Junfeng;Guo Peng;Zhao Xin;Wang Keke;Yang Feiyu;Shen Jie;Zhang Zhihua(Research Center for Chemical Injury and Emergency and Critical Medicine of Fudan University&Key Laboratory of Chemical Injury and Emergency and Critical Medicine of Health Commission of Shanghai City&Center of Emergency and Critical Medicine,Jinshan Hospital Affiliated to Fudan University,Shanghai,200540,P.R.China;Cardiac Ultrasound Room,Jinshan Hospital Affiliated to Fudan University,Shanghai,200540,P.R.China)
出处
《老年医学与保健》
CAS
2022年第4期856-861,共6页
Geriatrics & Health Care
基金
上海市公共卫生体系建设三年行动计划(2020—2022年)重点学科建设计划基金(GWV-10.1-XK26)
金山区科委基金(2018-3-25)。
关键词
老年
脓毒症
心肌损伤
超声心动图
炎症因子
心肌酶
elderly
sepsis
myocardial injury
echocardiography
inflammatory factor
myocardial enzyme
