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腹膜炎诱导脓毒症大鼠早期死亡的可能生物标志物。

Possible biomarkers of early mortality in peritonitis-induced sepsis rats.

机构信息

Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, ROC, Taiwan.

出版信息

J Surg Res. 2013 Jul;183(1):362-70. doi: 10.1016/j.jss.2013.01.022. Epub 2013 Jan 31.

DOI:10.1016/j.jss.2013.01.022
PMID:23769019
Abstract

BACKGROUND

Sepsis induced by cecal ligation and puncture (CLP) is accompanied by circulatory failure, multiple organ dysfunction syndrome, metabolic acidosis, and electrolyte imbalance in rats. However, it remains uncertain which parameters can be used to predict the mortality of septic rats. Thus, the aim of this study was to examine which possible biomarkers were associated with mortality in the CLP-induced sepsis model.

MATERIALS AND METHODS

After the carotid artery and vein were cannulated, rats were subsequently subjected to CLP or sham operation. The changes of hemodynamics, biochemical variables, blood gas, and electrolytes were monitored during the 18-h observation.

RESULTS

The CLP surgery caused circulatory failure, multiple organ dysfunction syndrome, metabolic acidosis, electrolyte imbalance, and death. Compared with survivors, nonsurvivors showed significant difference in (1) blood glucose; (2) lactate dehydrogenase, alanine aminotransferase, aspartate aminotransferase, creatinine, and blood urea nitrogen in serum; and (3) base excess, HCO3(-), PaCO2, potassium, and calcium in whole blood at 9 h after CLP. No significant difference in blood pressure, heart rate, pressor response to noradrenaline, rectal temperature, total protein, albumin, PaO2, and sodium was observed between nonsurvivors and survivors. However, after multifactor dimensionality reduction analysis, the union of HCO3(-) and blood glucose had the biggest testing balanced accuracy.

CONCLUSIONS

These results indicate that HCO3(-) plus blood glucose serves as the best biomarker of early death in rats with CLP-induced sepsis. Thus, these parameters could guide experimental procedures for making the right interventions when utilizing CLP as a sepsis model in rats.

摘要

背景

盲肠结扎穿刺(CLP)诱导的败血症会导致大鼠循环衰竭、多器官功能障碍综合征、代谢性酸中毒和电解质失衡。然而,目前尚不确定哪些参数可以用于预测败血症大鼠的死亡率。因此,本研究旨在探讨哪些可能的生物标志物与 CLP 诱导的败血症模型中的死亡率相关。

材料和方法

颈动、静脉插管后,大鼠随后接受 CLP 或假手术。在 18 小时观察期间,监测血流动力学、生化变量、血气和电解质的变化。

结果

CLP 手术后导致循环衰竭、多器官功能障碍综合征、代谢性酸中毒、电解质失衡和死亡。与幸存者相比,非幸存者在以下方面存在显著差异:(1)血糖;(2)血清中乳酸脱氢酶、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、肌酐和血尿素氮;(3)CLP 后 9 小时全血中的碱剩余、HCO3(-)、PaCO2、钾和钙。非幸存者和幸存者之间的血压、心率、去甲肾上腺素升压反应、直肠温度、总蛋白、白蛋白、PaO2 和钠无显著差异。然而,经过多因素降维分析,HCO3(-)和血糖的联合具有最大的检验平衡准确性。

结论

这些结果表明,HCO3(-)加血糖可作为 CLP 诱导败血症大鼠早期死亡的最佳生物标志物。因此,这些参数可以指导实验程序,在使用 CLP 作为大鼠败血症模型时做出正确的干预。

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