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实验性糖尿病酮症酸中毒家兔Ⅰ型肺泡上皮损伤和修复状况研究
作者:顾小军  
单位:东南大学附属南京第二医院
关键词:糖尿病酮症酸中毒  碱性磷酸酶  血小板衍生生长因子  
分类号:
出版年·卷·期(页码):2011·39·第四期(0-)
摘要:

目的:研究糖尿病酮症酸中毒家兔Ⅰ型肺泡上皮结构和功能的变化,探讨其损伤及修复机制。方法:新西兰家兔12只,随机分为实验组(DK组)和对照组(NS组)各6只,DK组家兔给予链脲佐菌素(STZ)150mg•kg-1(DK组,n=6)和四氧嘧啶(alloxen)150mg•kg-1,NS组给予等剂量生理盐水(NS组,n=6),72h后检测动脉血气,处死动物,取肺标本进行血小板衍生生长因子(PDGF)、肺光镜、Ⅰ型肺泡上皮超微结构、酸性磷酸酶(ALPase)、碱性磷酸酶(ALPase)细胞组织化学等检查。结果:1、实验组血气72小时后皆达到糖尿病酮症酸中毒标准,对照组正常。2、实验组肺光镜下可见明显肺部渗出、肺泡腔可见炎性细胞、肺泡隔增宽、肺出血等改变,对照组无异常。3、PDGF免疫组织化学观察可见DK组肺泡壁和微血管内表达较对照组明显增高。4、实验组Ⅰ型肺泡上皮超微结构可见细胞膜结构模糊、基底膜增厚、细胞膜外高电子物质聚集等损伤;对照组无异常。5、ALPase检查:Dk组动物细胞膜上ALPase活性显著减少,线粒体上酶活性也明显变少,NS组动物ALPase活性呈粗颗粒状存在于细胞膜、线粒体上。结论:1、糖尿病酮症酸中毒存在明显的肺泡Ⅰ型肺泡上皮的损伤、细胞膜功能下降;2、肺部在损伤的同时也启动了修复,PDGF参与了肺部修复的进程。

OBJECTIVE:To study the mechanism of the trauma and rehabilitate in type Ⅰ alveolar cells in diabetic ketoacidosis rabbit models. METHODS: 12 male New Zealand rabbits were divided into experimental groups (DK groups, n=6) and control groups (NS groups, n=6) randomly; Injection of streptozocin (150mg/kg) and alloxan monohydroate (150mg/kg) each in DK groups were received by injective venous, and NS groups were given the same dose normal sodium chloride. blood gas, blood electrolyte and urine acetone body were detected; All the animals were killed 72 hours later, blood gas,alkaline phosphates (ALPase) of cytohistochemical examination, ultrastructure were detected. RESULTS: 1、Plasma glucose concentration values were >17 mmol/L and urine acetone body appeared in all DK groups;2、inflammatory cellular exudation were shown in DK groups.3、The activity of PDGF immunohistology in DK groups were shown;4、thickening of the alveolar basement membrane and air-blood barrier,Type Ⅰalveolar cell and capillary endothelium damages were observed. 5、The activity of alkaline phosphates was lost in type Ⅰ alveolar cells. No changes were shown in NS groups. CONCLUSION: 1、DKA induce type Ⅰ alveolar cells lesion, membranous structure spoiled occupy important action.2、The rebuild was started up at the same time with injury in DKA, the factor of PDGF participated in the process of restoring in DKA lungs.

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