内毒素血症兔血浆内毒素及组织病理动态改变与卫气营血辨证相关性研究

摘要

目的 观察内毒素血症兔不同时相的血浆内毒素及脏器组织病理学改变,探讨其与卫气营血阶段性辨证及传变的相关性.方法 将50只新西兰大耳白兔随机分成空白组8只和1阶段(攻毒后2h内)组14只、2阶段(攻毒后2～6 h)组14只、3阶段(攻毒后6～ 36 h)组14只,采用静脉注射大肠杆菌内毒素的方法建立内毒素血症模型,观察不同时相血浆内毒素及肺、肝、肾、心脏组织病理学改变.结果 1阶段组及2阶段组血浆内毒素阳性率较空白组明显升高(P＜0.05),3阶段组与2阶段组比较,血浆内毒素阳性率亦明显升高(P＜0.05).1阶段组与2阶段组比较血浆内毒素阳性率差异没有统计学意义(P＞0.05).1阶段组肺、肝、肾、心脏病理均有轻微改变,少量炎细胞浸润、细胞肿胀是其主要特征;2阶段出现明显炎细胞浸润及脂肪变性,部分组织出现坏死;3阶段组肺、肝、肾组织均出现大量炎细胞浸润,有明显的细胞坏死.结论 内毒素血症兔血浆内毒素含量与病情轻重相关;1阶段病理改变与卫分证病机相关,2阶段病理改变与气分证病机相关,3阶段病理改变与营血分证病机相关.%Objective To observe plasma endotoxin and pathology changes of lung, liver, kidney and heart at different phases of endotoxemia rabbit, and explore their correlation with differentiation of Weiqiyingxue syndrome. Methods Fifty rabbits were randomly divided into four groups: normal group with 8 rabbits, 1st phase group with 14 rabbits which observed within 2 hours after LPS-infection, 2nd phase group with 14 rabbits which observed within 2-6 hours after injection, and 3rd group with 14 rabbits which observed within 6-36 hours after injection. The endotoxemia model rabbits was made by injecting LPS. Then these rabbits' plasma endotoxin and pathology changes of lung, liver, kidney and heart were observed. Results Positive rate of plasma endotoxin of 1st phase group and 2nd phase group was higher than that of normal group (P<0.05), and positive rate of plasma endotoxin of 3rd phase group was higher than that of 2nd phase group (P<0.05), but the difference between 1st phase group and 2nd phase group was not significant (P> 0.05). At 1st phase, lung, liver, kidney and heart all behaved slightly pathology changes, some invasive inflammatory cells and cellular swelling were major characteristic of 1st phase. There were more invasive inflammatory cells and more fatty change at 2nd phase, and there was necrosis in some tissues. At 3rd phase, there were abundant invasive inflammatory cells and obvious necrosis, especially in lung, liver and kidney. Conclusion Endotoxemia rabbit's plasma endotoxin relates with the severity of disease. The pathology changes of 1st phase are related with Weifen Syndrome, that of 2nd phase with Qifen Syndrome, and that of 3rd phase with Yingfen and Xuefen Syndrome.