Study On The Impact Of Different Levels Intensive Glycemic Control On Pulmonary Vascular Endothelial Cells In Rats With Sepsis

Objective: This study was designed to observe the impact of different levels intensive glycemic control onpulmonary vascular endothelial cell damage, explore the protective effect and its possible mechanism of thedifferent levels intensive glycemic management on the pulmonary vascular endothelial cell damage ofsepsis.Methods: The sepsis model of rat was duplicated by cecal ligation and puncture. Forty Sprague-Dawleyrats were randomly divided into five groups (n=8): sham operation group (group sham), sepsis group(group CLP), glycemic control A group (group A), glycemic control B group (group B), and glycemiccontrol C group (group C). In group sham, rat were not ligated and punctured to caecum, and othertreatment were same as those in group CLP．In group CLP, the blood glucose was not controlled. In groupA, the blood glucose was controlled between4.4to6.1mmol/L. In group B, the blood glucose wascontrolled between6.2to8.3mmol/L. In group C, the blood glucose was controlled between8.4to10.0mmol/L. The levels of blood glucose were monitored once an hour. Serum levels of TNF-α，ESM-1were detected by euzymelinked immunosorbent assay (ELISA). The histopathologic changes of lung tissuewere observed and the myocardial histopathologic score was counted by optical microscope, and the evelsof ESM-1in lung tissue was examined by Immunohistochemical method and In SituHybridizationTechnique.Results: The serum levels of TNF-α，ESM-1in CLP group were significant higher than the Sham groupand group A,B,C（P <0.05）. The serum levels of TNF-α，ESM-1in group A,B,C group were all higher thanSham group（P<0.05）；Group A was significant lower than group B、C（P<0.05）, group B was lower thangroup C（P<0.05）.The pathological grading of lung tissue injury in CLP group and group A,B,C weresignificant higher than in sham group（P<0.05）;howerelver, CLP group was higher than group A,B,C（P<0.05）,group A was lower than group B,group B was lower than group C（P<0.05）.The levels ofESM-1in lung tissue in CLP group and group A,B,C were obvious higher than in sham group（P<0.05）, thehigh expression of cases in CLP group were most, group C, B, A reduce in turn.the level of ESM-1inCLP group was significant difference compared with group A（P<0.05）, compared with group B and groupC were no significant difference（P<0.05）;The levels of serum ESM–1was significantly positively relatedto the level of serum TNF–α and the degree of lung tissue injury（P<0.01）;The correlation coefficient ofthe serum levels of ESM-1with serum TNF and lung tissue damage degree respectively were0.78、0.79;The correlation coefficient of the levels of ESM–1in lung tissue with serum TNF–α and lung tissuedamage degree respectively were0.48、0.73; The correlation coefficient of the serum levels of TNF–αwith the lung tissue damage degree was0.76（P<0.01）.Conclusion:1. Sepsis has Pulmonary vascular endothelial damage,and the levels of TNF–α, ESM-1werehigher; With the pulmonary vascular endothelial damage degree aggravating, the level of TNF-α and ESM–1were more higher;2. The pulmonary vascular endothelial damage in septic rats and levels of TNF–α, ESM-1Significantlyreduced with the intensive glycemic control; May be intensive glycemic control has certain inhibitoryeffect for expression level of TNF alpha, ESM-1, and weakened the progress of inflammation to a certainextent;3. The level of blood glucose in4.4～6.1mmol/L might be significantly alleviate myocardial damage incomparison with it in the6.2～8.3mmol/L and8.4～10.0mmol/L.