| Objective: To study the effect of high altitude and cold conditions on the CLP rabbit model of severe abdominal infection,and to provide experience and clinical reference for the judgment and treatment of abdominal infection under special conditions.Methods: 120 New Zealand white rabbits were randomly divided into three groups with40 rabbits in each group,taking altitude and temperature as the overall research factors;In group B,the altitude was 1000 meters and the temperature was-5℃;In group C,the altitude was 5000 meters and the temperature was-25 ℃.Before the experiment,the three groups of experimental animals were placed in the simulated plateau environment animal feeding cabin under their own conditions for 14 days,and the modeling experiment was carried out in the same altitude and temperature experimental cabin.The basic data of the experimental rabbits were measured before modeling,and the anal temperature,activity status and other basic conditions of the experimental animals were monitored every 4 hours after operation.The venous blood was drawn from the ear vein of the model rabbits 24 and 72 hours after operation,and the infection indexes(leukocyte count,C-reactive protein,percentage of neutrophils,procalcitonin,interleukin-6 and tumor necrosis factor)in the blood were detected-α)As well as creatinine,transaminase,albumin,prealbumin and other indicators.At 72 hours after operation,the animals were killed normally,and the ascites were extracted and sent to culture in time.The liver,kidney and intestinal epithelial tissues of the experimental animals were selected for pathological observation.The control group was not treated with cecal ligation and perforation modeling,the other steps were the same as the experimental group.Statistical software spss21.0 was used to analyze the relevant data,and P< 0.05 was recorded as statistically significant.Results: 1.The mortality of three groups of CLP rabbit models at different altitudes was higher than that of the control group(P < 0.05).The survival rates of A2,B2 and C2 groups were 65.0%(13 / 20),35.0%(7 / 20)and 10.0%(2 / 20).2.With the increase of altitude and the decrease of temperature,the survival rate of CLP model rabbits gradually decreased(P <0.01)..2.Within 24 hours after operation,there were significant differences in infection data between the experimental group and the control group(P < 0.05).There was no significant difference in WBC,CRP,neut% between the experimental group and the control group(P >0.05),but PCT,IL-6,TNF% in B2 and C2 groups-α There were significant differences between the two groups(P < 0.05);PCT,IL-6 and TNF were compared between two groups72 hours after operation-α The difference was statistically significant(P < 0.05).Pearson correlation analysis showed that PCT,TNF-α There was a positive correlation between WBC and high altitude cold(r = 0.288,r = 0.368,P < 0.05),but no correlation between WBC and CRP and high altitude cold(r = 0.462,r = 0.397,P > 0.05)3.There were significant differences in ALB,PAB,SCR and AST between the three groups 24 hours after operation and the control group(P < 0.05).There were no significant differences in ALB,PAB,SCR and AST between the three groups(P > 0.05).There were significant differences in ALB,PAB,SCR and ast between the three groups 72 hours after operation(P < 0.05).4.After the operation,51,69 and 107 strains of pathogenic bacteria were isolated from A2,B2 and C2 groups,of which Gram-negative bacteria accounted for 52.94%(27 / 51),49.27%(34 / 69)and 42.06%(45 / 107)respectively,and Gram-positive bacteria accounted for 29.41%(15 / 51),34.78%(24 / 69)and 43.93%(47 / 107)respectively.The pathology of important organs in each experimental group showed that with the increase of altitude and the decrease of temperature,the destruction of tissue structure was aggravated,and the infiltration of inflammatory factors was increased.Conclusion: 1.PCT、TNF-α it is more sensitive than WBC and CRB,and can be used as an important reference for judging the severity of infection under special conditions;2.Severe abdominal infection in high altitude and cold environment can aggravate the damage of important organ function,accelerate the destruction of intestinal barrier,and affect the nutritional metabolism of the body.3.High altitude and cold conditions are important factors affecting the infection degree and mortality of CLP model rabbits,and with the increase of altitude and the decrease of temperature,the infection degree and mortality increased gradually;4.The changes of intestinal flora in the environment of high altitude and cold lead to the difference of pathogenic flora in the occurrence of intra-abdominal infection with that in plain areas,which may further affect the process of intra-abdominal infectious diseases,which is worthy of further study. |
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