脓毒症家兔胰岛组织损伤与血糖变化的研究

目的：通过制备脓毒症家兔模型，研究其血糖变化与胰腺组织的病理改变之间的关系，探讨脓毒症高血糖的发生机制。方法选择6~8周龄1.7kg左右的清洁级新西兰家兔，用产CTX2M214型超广谱β2内酰胺酶大肠杆菌菌液静脉注射制备动物模型；对模型组和非模型组（正常组）家兔进行危重评分，监测48h内血糖、分析胰腺病理变化。结果（1）模型组的危重评分随时间进展逐渐升高，8h达峰值，之后开始逐渐下降，48h后仍高于注射菌液后2h水平；（2）模型组的血糖水平在最初4h内出现下降趋势，最低值（2.13±0.31）mmol/L，但8h后血糖水平升高，12h达峰值（12.27±2.40）mmol/L，至48h一直维持在较高值，明显高于正常组（P〈0.05）；（3）模型组4h、8h、48h胰腺组织病理损害评分分别为（5.17±0.75）分、（8.17±0.29）分、（13.67±0.76）分，较正常组的（0.38±0.48）分明显升高，表明对胰腺组织有损害，且随时间进展损害程度加重。结论脓毒症家兔高血糖发生与胰岛细胞损伤同时发生，胰岛素分泌相对不足可能是引起应激性高血糖发生的关键因素。

ObjectiveTo observe the blood glucose and pancreatic tissue pathological change in rabbit model with sepsis,and investigate the mechanism of hyperglycemia in sepsis. Methods6~8 weeks’ New Zealand rabbit about 1.7kg were choosen as the animal model with sepsis through injecting Escherichia Coli bacteria liquid via vein. The models were divided into a normal group and a model group,in order to carry out critically ill score,blood glucose monitoring and the analysis of islet pathological change within 48 hours.ResultsThe critically ill score of model group gradually raised in the progress,and reach the peak at 8h,and then began decreased,but still higher after 48hcompared with the level at 2h after bacteria liquid injected. The blood glucose levels of model group showed a decline trend during the first 4 h,the lowest was 2.13±0.31mmol/L,after 8 h the blood glucose significantly increased and remained at a higher level till 48 h,the peak was 12.27±2.40 mmol/L. That displayed an obvious difference compared with the normal group（P〈0.05）. Compared with normal group,islet tissue in model group presented obvious damage and the severity of damage increased with time.ConclusionThe blood glucose change should be related with islet damage in Rabbit with Sepsis,the deficiency of insulin secretion may play a critical role in the mechanism of hyperglycemia.