急性腹腔感染与胰岛素抵抗关系及炎症因子作用时间“窗”

The relationship between acute peritoneal infection with insulin resistance and the action window time of inflammatory factors

目的探讨急性腹腔感染大鼠早期葡萄糖代谢与炎症因子水平的关系。方法SD大鼠随机分为4组:A组,盲肠结扎穿孔(CLP)组;B组,腹腔脂多糖(LPS)注射组;C组,CLP加LPS注射组;D组,对照组。A,B,C组均为急性腹腔感染模型。检测各组血浆中不同时间点葡萄糖、胰岛素、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)的水平。HOMA法计算胰岛素抵抗指数(IRI),以此评价胰岛素抵抗(IR)程度。结果大鼠急性腹腔感染组(A、B、C组)早期血浆中葡萄糖水平及IRI升高,6 h达峰值。IRI变化与TNF-α,IL-6水平的对数值之间呈正相关(r=0.609和0.755)。接受LPS注射者(B、C组)IL-6升高较未接受LPS注射组(A组)升高明显。IL-6较TNF-α维持时间延长。结论急性腹腔感染早期可出现IR;TNF-α和IL-6与IR的程度呈正相关,不同感染模型的炎症因子水平变化存在差异,其作用时间"窗"不同。

Objective To study the correlation of early glucose metabolism and inflammatory factors in rats with acute peritoneal infection. Methods Rats were randomly divided into 4 groups ： A group, rats subjected to cecal ligation plus puncture （ CLP ） ; B group, to intraperitoneal injection of lipopolysaccharide （ LPS ） ; C group, to CLP combined with intraperitoneal injection of LPS C;D group, control group. A, B, C group all were to produce acute peritoneal infection. The blood glucose, TNF-α and IL-6 and insulin were detected, and insulin resistance index （ IRI ） was calculated to evaluate the extent of insulin resistance. Results Blood glucose level and IRI were elevated in the early stage in A, B, C groups, and reached a peak level at 6 h. IRI changes in the early stage had a positive correlation with TNF-α and IL-6. The rats that received LPS injection presented （ B, C groups ） mainly had a higher level of IL-6. And 1 L-6 evaluated persisted longer than TNF-α did. Conclusions Our results suggest that insulin resistance can occur in the early stage of acute peritoneal infection. Although differences exist in their action time, both TNF-α and IL-6 have a positive relationship with insulin resistance.