大鼠蛛网膜下腔出血致多器官功能障碍综合征模型的建立

Establishment of a rat model of subarachnoid hemorrhage induced by multiple organ dysfunction syndrome

目的建立符合临床实际、简便易行的蛛网膜下腔出血(SAH)致多器官功能障碍综合征(MODS)模型。方法采用大鼠Willis环注血法建立SAH致MODS模型,48只Wistar大鼠随机分为正常对照组、假手术组、SAH 后6个亚组(4,12,24,36,48,h72组),记录各时相点大鼠SAH后的症状、体征,检测外周血WBC、肝肾功能、心肌酶学改变。光镜下观察肺、小肠、肝和肾组织病理变化,依据全身炎症反应综合征(SIRS)和MODS的诊断标准判断 SIRS和MODS的发生率。结果 (1)假手术组与正常对照组相比,其呼吸、心率、体温及外周血WBC、ALT、AST、 BUN、Cr、CK的差异无显著意义(P>0．05);SAH组的上述各项指标均高于正常对照组、假手术组(P<0．01),并且在 24～36h变化最明显。(2)大鼠SAH后各时相点各脏器组织均有不同程度的炎性损害,SAH组在24-36h时相点的脏器病理变化最显著,在48h稍有减轻,72h时相点仍可见炎性损害。(3)SAH组SIRS的发生率为100％;MODS发生率为69．4％,死亡率为38．9％。结论大鼠Willis环注血法可成功建立SAH致MODS的实验动物模型。

Objective To estabilish a easily made model that would imitate clinical features of multiple organ dysfunction syndrome（MODS） resuliting from subarachnoid hemorrage（SAH）. Modhods Rat model of SAH was formed by injecting arterial blood into the Willis＇circle. Forty-eight Wistar rats were randomly divided into three groups： normal control group（ n =6） ,shamoperative group（ n = 6） and SAH group（ n = 36）including 4,12,24,36,48 and 72h subgroups. Changes of symptoms and signs including temperature, heart rate and respiration of each group were recorded. The WBC count and biochemical indices were assayed. Pathological changes in lung, liver, intestines and kidney were recorded through optical microscopy. Incidences of systemic inflammatory response syndrome （SIRS） and MODS were diagnosed according to the diagnostic criteria. Remits （ 1 ） There were no significant differences in temperature, heart rate, respiration, WBC count, and the levels of ALT, AST, BUN, Cr and CK between normal control group and sham-operative group （ P 〉 0.05）. The rats of SAH group had obviously higher temperature, heart rate,respiration,WBC count and levels of ALT, AST, BUN, Cr and CK than the normal control group and sham-operative group （ P 〈 0.01 ）, and the changes were most obvious at 24 - 36 hour point. （2） Inflammatory injuries in varying drcgrees were observed in organs at each time point after SAH. The pathological changes in the organs were peaked at 24- 36 h, slightly alleviated at 48 h, and still could be observed at 72 h. （3） Incidences of SIRS, MODS and mortality were 100%, 69.4% and 38.9% respectively after SAH in SAH group. Conclusion An experimental animal model of MODS can be established successfully through SAH by injecting arterial blood into the Willis＇ circle in rats.