首页|重组人血小板生成素对D-氨基半乳糖诱导急性肝衰竭大鼠血小板的影响

重组人血小板生成素对D-氨基半乳糖诱导急性肝衰竭大鼠血小板的影响

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目的 通过观察急性肝衰竭(ALF)过程中血小板计数(PLT)、血小板生成素(TPO)、肝功能的动态变化,评估重组人血小板生成素(rhTPO)对ALF大鼠PLT及肝功能的影响.方法 将 24 只雄性SD大鼠按照随机数字表法分为模型组、TPO组及白细胞介素-11(IL-11)组,每组 8 只.所有大鼠经腹腔注射D-氨基半乳糖(D-GalN,1 500 mg/kg,72 h内分次给药)诱导构建ALF模型.制模后,TPO组皮下注射rhTPO 15 μg/kg,连续 5 d;IL-11 组皮下注射IL-11 0.45 mg/kg,连续 5d.于制模前及制模后 1、3、5、7、12 d静脉采血进行全血细胞检测,并用酶联免疫吸附试验(ELISA)检测血清TPO水平;于制模前及制模后 1、3、5 d检测肝功能指标丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBil)、白蛋白(ALB);并于制模后 12d处死大鼠,用苏木素-伊红(HE)染色观察肝组织病理改变.结果 3 组大鼠均于制模后 24~48 h各死亡 2 只.HE染色显示,3组ALF大鼠于制模后12d均可见到肝细胞大片状坏死、肝小叶结构紊乱,网状支架塌陷,肝窦充血、出血,及炎症细胞片状浸润.各组大鼠制模后 1d血清ALT、AST及TBil水平均明显升高,随后下降;ALB水平于制模后 1d明显下降后回升,但 3 组间肝功能指标变化趋势差异无统计学意义.3 组大鼠制模后 1dPLT快速下降,之后随着肝功能改善逐渐恢复;其中制模后 7dTPO组PLT升至峰值并显著高于模型组[PLT(×109/L):1 673.3±347.5 比 855.3±447.0,P<0.05],而IL-11 组PLT与模型组差异无统计学意义[PLT(×109/L):1 350.3±386.6 比 855.3±447.0,P>0.05].3 组大鼠制模后 1d血清TPO水平均明显升高,随后下降,5 d时降至谷值,但 3 组间血清TPO水平变化趋势差异无统计学意义.结论 ALF大鼠PLT早期快速下降,并随着肝功能改善而逐渐恢复,血清TPO水平出现先升高后下降的变化.注射rhTPO可显著提升ALF大鼠PLT,但对肝功能及动物生存期无明显影响.
Effect of recombinant human thrombopoietin on platelets in rats with D-galactosamine salt-induced acute liver failure
Objective To evaluate the effects of recombinant human thrombopoietin(rhTPO)on platelet count(PLT)and liver function in acute liver failure(ALF)rats by observing the dynamic changes of PLT,thrombopoietin(TPO)and liver function during ALF.Methods Twenty-four male Sprague-Dawley(SD)rats were divided into model group,TPO group and interleukin-11(IL-11)group using a random number table method,with eight rats in each group.All rats were intraperitoneally injected with D-galactosamine(D-GalN,1500 mg/kg,dosed within 72 hours)to induce the ALF model.After modeling,rats in TPO group was received subcutaneous injection of 15 μg/kg of rhTPO for 5 days,and rats in IL-11 group was received subcutaneous injection of 0.45 mg/kg of IL-11 for 5 days.Venous blood samples were collected before and at 1,3,5,7 and 12 days after molding for whole blood cell detection.The level of TPO in serum was detected by enzyme-linked immunosorbent assay(ELISA).Liver function indexes including serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBil)and albumin(ALB)were measured before and at 1,3 and 5 days after modeling.The rats were sacrificed 12 days after the modeling,and the pathological changes of liver tissue were observed by hematoxylin-eosin(HE)staining.Results Two rats in each group died within 24-48 hours after modeling.HE staining showed that all three groups of ALF rats showed large flake necrosis of hepatocytes,disorder of hepatic lobular structure,mesh scaffold collapse,hepatic sinus congestion and hemorrhage,and flake infiltration of inflammatory cells on day 12 after modeling.The levels of serum ALT,AST and TBil of rats in each group were significantly increased 1 day after modeling and then decreased.The level of ALB decreased significantly on the first day after modeling and then increased,but there was no significant difference in the trend of liver function indexes among the three groups.PLT in the three groups decreased rapidly on day 1 after modeling,and then recovered gradually with the improvement of liver function.The PLT of the TPO group rose to the peak value 7 days after molding and was significantly higher than that of the model group[PLT(×109/L):1673.3±347.5 vs.855.3±447.0,P<0.05],while there was no significant difference between the IL-11 group and the model group[PLT(×109/L):1350.3±386.6 vs.855.3±447.0,P>0.05].The level of serum TPO of the three groups increased significantly on day 1 after modeling,then decreased,and dropped to the lowest value on day 5,but there was no significant difference in the trend of serum TPO level among the three groups.Conclusions PLT in ALF rats decreased rapidly in the early stage and recovered gradually with the improvement of liver function,and the serum TPO level increased first and then decreased.Injection of rhTPO can significantly increase PLT in ALF rats,but has no significant effect on liver function and survival rate.

Acute liver failurePlateletThrombopoietinInterleukin-11

唐飞、梁静、景丽、刘刚、王凤梅

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天津医科大学三中心临床学院消化(肝病)科,天津 300170

天津市重症疾病体外生命支持重点实验室,天津 300170

天津市人工细胞工程技术中心,天津 300170

天津市肝胆疾病研究所,天津 300170

天津医科大学三中心临床学院检验科,天津 300170

天津市东丽医院消化科,天津 300399

天津市第一中心医院器官移植重点实验室,天津 300192

天津市肝癌分子诊断与治疗重点实验室,天津 300192

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急性肝衰竭 血小板 血小板生成素 白细胞介素-11

天津市卫生健康科技项目天津市医学重点学科(专科)建设项目

TJWJ2022XK029TJYXZDXK-034A

2024

中华危重病急救医学
中华医学会

中华危重病急救医学

CSTPCD北大核心
影响因子:3.049
ISSN:2095-4352
年,卷(期):2024.36(2)
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