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目的建立高血糖大鼠肝损伤模型,探讨胰岛素强化治疗的疗效。方法利用链脲佐菌素(STZ)和D-半乳糖胺(D-gal)注射建立高血糖肝损伤模型大鼠,分为强化治疗组(血糖控制在6~8mmol/L)和常规治疗组(血糖控制在9~12mmol/L),分别于损伤模型制备前及制备后1、3、5、7d处死大鼠,经腹主动脉抽血检测丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(T-Bil)、白蛋白(ALB)、总蛋白(TP)、碱性磷酸酶(ALP)含量。取上述处死的大鼠肝脏组织,制作病理切片,行HE染色观察。取第7天大鼠肝组织行组织电镜观察。结果成功建立了大鼠高血糖肝损伤模型。胰岛素强化治疗可明显降低模型大鼠的死亡风险,强化治疗组病死率明显低于常规治疗组(P<0.01);胰岛素强化治疗后,肝脏ALT、AST、T-Bil明显降低,ALB、TP升高,ALP降低(P<0.05或P<0.01);HE染色及透射电镜结果表明肝细胞变性坏死显著减少。结论胰岛素强化治疗可降低高血糖肝损伤大鼠的病死率,减轻肝脏损伤程度,具有很好的临床应用前景。
Objective To establish a model of hepatic injury in hyperglycemic rats and investigate the curative effect of intensive insulin therapy. Methods The model rats with hyperglycemia induced by STZ and D-gal injection were divided into intensive treatment group (blood glucose control of 6 ~ 8mmol / L) and conventional treatment group (Blood glucose control in 9 ~ 12mmol / L), respectively, before injury model preparation and 1,3,5,7 d after the preparation of rats were killed, aorta blood was measured by alanine aminotransferase (ALT), aspartate AST, T-Bil, ALB, total protein (TP) and alkaline phosphatase (ALP) were measured. Take the above sacrificed rat liver tissue, making pathological sections, HE staining was observed. Tissue electron microscopy was performed on day 7 of rat liver tissue. Results Successful establishment of a rat model of hyperglycemic liver injury. Intensive insulin therapy could significantly reduce the risk of death in model rats, and the mortality in intensive treatment group was significantly lower than that in conventional treatment group (P <0.01). After insulin intensive treatment, ALT, AST and T-Bil in liver decreased significantly, (P <0.05 or P <0.01). The results of HE staining and transmission electron microscopy showed that the number of hepatic degeneration and necrosis was significantly reduced. CONCLUSION: Intensive insulin therapy can reduce the mortality of rats with hyperglycemic liver injury and reduce the degree of liver injury. It has a good clinical application prospect.