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目的通过检测家兔急性胆囊炎模型血清肿瘤坏死因子-α(TNF-α)和C-反应蛋白(CRP)的浓度变化,以探讨生长抑素联合抗生素应用对急性胆囊炎的疗效及其可能的机理。方法建立家兔急性胆囊炎动物模型,45只家兔按随机数字表法均分为空白组、对照组及实验组3组。对照组家兔给予头孢唑啉钠及甲硝唑静脉注射,实验组家兔在对照组基础上加用生长抑素皮下注射,空白组家兔皮下注射等体积的生理盐水。给药3 d后,采用酶联免疫法测定血清中TNF-α及CRP浓度,并于光镜及透射电镜下观察各组家兔胆囊组织的病理学改变及超微结果改变。结果术后3 d实验组家兔血清TNF-α浓度为(401.6±48.7)pg/ml,明显低于空白组的(806.7±61.2)pg/ml和对照组的(767.3±67.4)pg/ml(P=0.000;P=0.000),而后2组之间的差异无统计学意义(P=0.196);实验组家兔血清CRP浓度为(16.2±1.1)mg/L,明显低于空白组的(72.8±8.9)mg/L和对照组的(55.4±1.2)mg/L(P=0.000;P=0.000),而空白组又明显高于对照组(P=0.018)。光镜观察结果:与空白组和对照组相比,实验组家兔胆囊纤维素及脓性渗出物明显减少,固有层水肿明显减轻,中性粒细胞浸润明显减少,炎症反应明显减轻;透射电镜观察结果:胆囊组织细胞间连接相对完整,线粒体和内质网水肿以及空泡变性明显减轻。结论生长抑素能降低家兔急性胆囊炎模型血清TNF-α和CRP浓度,减轻胆囊的炎症反应,并对胆囊黏膜细胞具有一定的保护作用。
Objective To investigate the effect of somatostatin combined with antibiotics on acute cholecystitis and to explore its possible mechanism by detecting the changes of serum tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) mechanism. Methods The animal model of acute cholecystitis in rabbits was established. 45 rabbits were divided into blank group, control group and experimental group according to random number table. The rabbits in the control group were given cefazolin sodium and metronidazole intravenously. The rabbits in the experimental group were injected subcutaneously with somatostatin on the basis of the control group, and the rabbits in the blank group were injected subcutaneously with the same volume of normal saline. After 3 days of administration, the concentrations of TNF-α and CRP in serum were determined by enzyme-linked immunosorbent assay. The pathological changes and ultrastructural changes of gallbladder tissues were observed under light microscope and transmission electron microscope. Results The level of TNF-α in the experimental group was (401.6 ± 48.7) pg / ml 3 days after operation, which was significantly lower than that of the control group (806.7 ± 61.2 pg / ml) and the control group (767.3 ± 67.4 pg / ml (P = 0.000; P = 0.000). There was no significant difference between the two groups (P = 0.196). The serum CRP level in the experimental group was (16.2 ± 1.1) mg / L, which was significantly lower than that in the blank group (72.8 ± 8.9) mg / L in the control group and (55.4 ± 1.2) mg / L in the control group (P = 0.000; P = 0.000), while the blank group was significantly higher than the control group (P = 0.018). Light microscopy results: compared with the blank group and the control group, the experimental group of rabbit gallbladder cellulose and purulent exudate decreased significantly reduced the edema of the lamina propria, neutrophil infiltration was significantly reduced inflammatory response was significantly reduced; transmission Electron microscopy results showed that the cytoplasmic junctions of gallbladder tissues were relatively intact, mitochondria and endoplasmic reticulum edema and vacuolar degeneration were significantly reduced. Conclusion Somatostatin can reduce the levels of serum TNF-α and CRP in rabbits with acute cholecystitis, relieve the inflammation of the gallbladder and have a protective effect on gallbladder mucosal cells.