COPD模型大鼠不同分期下血气分析变化与肝功能损害程度的相关性研究

Research on correlation between blood gas changes and hepatic lesion in different stages of COPD in rats

关键词:  慢性阻塞性肺疾病  动脉血气分析  肝功能  系统相关性

Key words:  chronic obstructive pulmonary disease  arterial blood gas analysis  liver function  systemic correlation

摘要:

[目的] 为拓展“慢阻肺与中医多系统相关”理论的现代研究与应用范围,本实验立足于肺病及肝,从缺氧角度探讨慢性阻塞性肺疾病(COPD)模型大鼠不同分期下血气分析变化与肝功能损害程度的相关性.[方法] 清洁级健康雄性 Wistar 大鼠24只,随机分成3组:正常组(A组),COPD模型组(B组)及COPD急性加重组(C组),每组8只.采用改良熏香烟加气管内注脂多糖的方法建立COPD模型,造模结束后第2天滴加脂多糖建立COPD急性加重模型.6 h后取血进行血气分析及肝功能检测,光镜、电镜下观察肝脏病理及超微结构改变.[结果] 与A组比较,B组pH值、动脉氧分压(PaO₂)降低(P<0.05),C组pH值、PaO₂降低(P<0.01);两实验组PaO₂和血氧饱和度(SaO₂)显著下降(P<0.01),而二氧化碳分压(PaCO₂)显著升高(P<0.01);C组与B组比较,pH下降(P<0.01),PaO₂下降(P<0.01),PaCO₂升高(P<0.01),SaO₂下降(P<0.01);与A组比较,B组大鼠谷丙转氨酶(ALT)升高(P<0.05)、总结合胆红素(TBIL)显著升高 (P<0.01),白蛋白(ALB)下降(P<0.05),碱性磷酸酶(AKP)无统计学意义.C组大鼠ALT、TBIL、AKP显著升高(P<0.01),ALB显著下降(P<0.01);与B组比较,C组ALT升高(P<0.05)、TBIL显著升高(P<0.01),ALB下降(P<0.05),AKP升高(P<0.05).且 pH值、PaO₂与ALT、TBIL结果呈显著负相关(P<0.01);PaCO₂与ALT、TBIL结果呈显著正相关(P<0.01).A组、B组、C组光镜、电镜下肝脏损伤程度依次加重.[结论] COPD模型大鼠随着缺氧、二氧化碳潴留程度的增加,肝功能损害进一步加重.

Abstract:

[Objective] To exploit the modern study and application of the theory“COPD has correlation with multiple system”, this experiment based on “lung disease leading to liver disease”. It explored the correlation between the blood gas changes and the hepatic lesion in different stagings of the COPD from hypoxia aspect. [Methods] Rats were divided into three groups randomly with 8 rats in each group: the blank group (A), the COPD group (B), and the acute exacerbation of COPD group (C). The model of COPD was established by the improved passive smoking with LPS dropped into the trachea. Based on the model of COPD in first stage, the model of acute exacerbation of COPD was established by dropping LPS into the trachea again. Six hours later, the liver function was detected, the arterial blood gas was analyzed and the pathological changes of liver were observed under light and electron microscopy. [Results] Compared with the group A, the pH value and PaO₂ of blood in the group B were decreased (P<0.05). These parameters was also decreased in group C (P<0.01). The arterial oxygen tension (PaO₂) and oxygen saturation (SaO₂) decreased significantly (P<0.01) in these two experimental groups, while the carbon dioxide partial pressure (PaCO₂) obviously increased (P<0.01); compared with group B, the PH value of group C was decreased (P<0.01), PaO₂ (P<0.01) and SaO₂ ware decreased (P<0.01); PaCO₂ was increased (P<0.01). Compared with group A, the content of ALT in group B was higher (P<0.05), TBIL was significantly increased (P<0.01), while ALB decreased (P<0.05). There was no significant difference in AKP. In group C, the contents of ALT, TBIL and AKP were all rose significantly (P<0.01); ALB was descend obviously. Compared with group B, the contents of ALT and AKP were higher (P<0.05); TBIL was significantly increased (P<0.01); ALB was decreased (P<0.05). Furthermore, the pH value and the PaO₂ had negative correlation with the ALT and the TBIL, while the PaCO₂ had positive correlation with the ALT and the TBIL significantly (P<0.01). The damage degree of the liver and lung tissue increased successively found under the light microscope and transmission electron microscopy in the group A, B and C. [Conclusion] With the exacerbation of hypoxia and the retention of carbon dioxide the hepatic function of the rats with COPD is further aggravated obviously.