MODSE模型的生理生化学及组织形态学研究

目的　探讨老年多器官功能障碍综合征 (multipleorgandysfunctionsyndromeintheelderly ,MODSE)的生理生化指标及组织形态学变化特点及其意义。方法　本实验采用盲肠结扎穿孔术 (cecalligationpuncture ,CLP)制作MODSE模型和青年多器官功能障碍综合征 (multipleorgandysfunctionsyndrome ,MODS)模型 ,并设立与以上两种模型相应的假手术对照组和未加任何处理的对照组 ;分别于术后 6,12 ,2 4,48和 72h监测生理生化学指标并同时采用常规HE染色法对各重要器官 (心、脑、肺、肝和肾 )的组织形态学变化进行研究。结果　MODSE组在 6h左右就可以观察到器官功能受到损害 ,2 4h左右达高峰且持续的时间很长 ( 72h还持续存在 ) ,而MODS组则在 2 4h左右才会出现器官功能受损且受损严重程度较MODSE组轻微 ,48h达高峰。结论　MODSE模型的器官功能障碍发生率较高 ,其器官结构与功能的损害发生亦较早而且严重 ,此结果为多器官功能衰竭死亡的法医学鉴定提供一定的实验依据。

Histological physiological and biochemical study on multiple organ dysfunction syndrome in the elderly

Objective To study the characteristics of organ function and structural injuries in the elderly with multiple organ dysfunction syndrome. Method 50 Wistar rats (25 three-month-old rats and 25 twenty-month-old rats) were anaesthetized and experienced cecal ligation puncture (CLP) operation, which were defined as MODSE group and MODS group respectively. 40 Wistar rats (20 three-month-old rats and 20 twenty-month-old rats) were anaesthetized and not experienced cecal ligation puncture operation, which were used as SOGE (sham operation group in the elderly) and SOG (sham operation group). At 6 h, 12h, 24h, 48h or 72h after operation, serum levels of alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, creatinine and total bilirubin were measured by automatic biochemistry analyzer. Organs (hearts, brains, lungs, livers, kidneys) were harvested. Paraffin sections were made and stained by conventional H.E procedure for histological examination. Results Based on histological investigations, physiological and biochemical measurements, organ dysfunction in MODSE group occurred at 6h after operation and peaked at 24 h after operations. Otherwise, organ injuries with MODS occurred at 24 h and peaked at 48 h after operation. Conclusion According to histological investigations, physiological and biochemical measurements, damages of organ dysfunction and structural damages in MODSE group occurred much earlier and more seriously. which may provide an experimental evidence for medico-legal certification of the death caused by MODS.