臺灣博碩士論文加值系統

敗血症是指因感染所引起之全身性發炎反應，儘管過去幾十年來醫學上有顯著的進步，但敗血症的致死率至今仍是居高不下，臨床上產生敗血症的病人中，以肺部感染為最多，腹腔感染則次之，而在敗血症關於胃潰瘍方面的研究更是相當不足。牛磺酸為膽汁及飲食中常見之胺基酸，褪黑激素是腦部松果體所分泌的一種激素，文獻指出均具有抗氧化的作用。因此本實驗以腹腔注射10 mg/kg格蘭氏陰性菌外膜的脂多醣 (lipopolysaccharide, LPS)誘發大鼠產生敗血症，於0、24小時抽血測量白血球數量，血糖值及體溫的改變，並於第21小時執行外科手術以人工胃液灌流三小時後，取出胃黏膜作各種參數分析，包括潰瘍面積、胃酸逆擴散之測定、血紅素含量、組織胺濃度、黏液產量、麩胺基硫(glutathione, GSH)、脂質過氧化(lipid peroxidation, LPO)、過氧化氫酶(catalase, CAT)、超氧化物岐化酶(superoxide dismutase, SOD)、穀胱甘肽過還原酶(glutathione reductase, GSH Rd)、穀胱甘肽過氧化酶(glutathione peroxidase, GSH Px)及脊椎過氧化酵素(myeloperoxidase, MPO)，以評估氧化性壓力及嗜中性球浸潤的程度，並探討牛磺酸與褪黑激素對敗血症之療效及可能機轉。結果發現牛磺酸與褪黑激素可能經由減少潰瘍面積、血紅素含量，增加黏液產量、麩胺基硫含量而有胃部保護作用，降低LPS所引起敗血症動物的死亡率。

Sepsis is the systemic inflammatory response to infection. In spite of marked advance in medicine, the mortality rates in septic patients are still rising. Sepsis can cause failures of multiple organs, including heart, lung, liver, kidney and gastrointestinal system. Global tissue hypoxia results in an imbalance between systemic oxygen delivery and demand, and is a key development of preceding multiple organ failure and death. Nevertheless, the mechanisms of gastric hemorrhagic ulcer in sepsis are unknown. Taurine is one of the most abundant amino acids in the body. Melatonin is secreted by the pineal gland. Both taurine and melatonin possess potential antioxidant effects. Whether these two drugs can ameliorate gastric hemorrhagic ulcer in septic rats is unknown. Intraperitoneal lipopolysaccharide (LPS; 10 mg/kg) was challenged to rats for 24 hours to induce sepsis. Animals were divided into four groups: (1) Sham operation (Sham) (2) Sham + melatonin (10、20、50 mg/kg); Sham + taurine (50、100、250 mg/kg) (3) LPS (4) LPS + melatonin; LPS + taurine. After gastric surgery, the rat stomachs were then irrigated for three hours with simulated gastric juice, and then to evaluate effects of melatonin and taurine on LPS-induced septic rats. At 0 and 24 hr after LPS treatment, the changes of white blood cell count, blood sugar, rectal temperature, gastric ulcerogenic factors (gastric acid back diffusion, histamine concentration, lipid peroxidation), gastric defensive parameters (gastric mucus and glutathione production in gastric mucosa), antioxidant effects (catalase, superoxide dismutase, glutathione reductase and glutathione peroxidase) were examined. The results showed that LPS produced severe gastric hemorrhagic ulcer and exacerbation of offensive factors while defensive parameters were decreased. These beneficial effects of melatonin and taurine may be attributed to reducing organ O2- levels and increasing activation of antioxidant enzymes (catalase, superoxide dismutase, glutathione reductase and glutathione peroxidase), thereby decreasing the mortality rates in LPS-induced septic rats.

中文摘要………………………………………………………………Ι
英文摘要………………………………………………………………Ⅱ
目錄……………………………………………………………………Ⅲ
表目錄…………………………………………………………………Ⅳ
圖目錄…………………………………………………………………Ⅴ
第一章 緒論………………………………………………………… 1
第二章 實驗材料和方法…………………………………………… 19
第三章 實驗結果…………………………………………………… 41
第四章 討論………………………………………………………… 47
第五章 結論………………………………………………………… 58
參考文獻………………………………………………………………59
表、圖及附錄…………………………………………………………69

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