血浆补体C5a预示创伤失血性休克大鼠肝脏损害严重性

Use of serum complement C5a as a predictive indicator of liver injury severity in traumatic rats withhemorrhagic shock

目的探讨血浆补体C5a和C5b-9是否能够预示大鼠创伤失血性休克时肝脏损害的严重程度。方法50只雄性健康Wistar大鼠被随机（随机数字法）分为正常组、模型1，3，6，24h组。用酶联免疫吸附方法（ELISA）检测血浆中总补体活性CH50、补体活性片断C5a和膜攻击复合物C5b－9，速率法检测血浆中谷草转氨酶。石蜡切片观察肝脏病理损害。结果在模型1h时，CH50显著上升并且达到最高值，3h开始下降，24h时达到最低点，1h与3，6，24h时点相比较，差异具有统计学意义（P〈0．05）；在正常组血中可以检测到少量的C5b－9，在模型1h时C5b－9显著上升达到峰值，与正常组、模型3，6，24h相比较差异均具有统计学意义（P〈0．05），3h时C5b－9开始下降，模型24h时降至最低；模型组3，6，24h时点血浆中C5a开始上升，与正常组相比较，差异均具有统计学意义（P〈0．05），模型24h组达到峰值；谷草转氨酶在模型1h显著上升，在24h达到峰值，24h组与其余模型组及正常组相比较差异具有统计学意义（P〈0．05）。结论创伤失血性休克时存在补体的大量活化，早期CH50、C5b-9上升；后期C5a上升。可以认为C5b-9是肝脏损害的启动因素。早期低水平的C5a可能是机体的一种自我保护措施，后期高水平的C5a作为自身不能代偿后的一种表现，作为后期疾病严重程度的一项预测指标。

Objective To discuss the feasibility of using serum complement CSa and C5b-9 as pre- dictive indicators of liver injury severity in traumatic rats with hemorrhagic shock. Method Fifty healthy male Wistar rats were randomly （random number） divided into normal group, model 1 hour group, model 3 hours group, model 6 hours group, and model 24 hours group. Plasma CHS0, CSa and C5b-9 were detected by using enzyme-linked immunosorbent assay, and rate method was used for determination of plasma aspar- rate aminotransferase. Paraffin sections of hepatic tissues were used to observe the damage of liver. Results In the model 1 h group, the CHS0 increased significantly and reached the highest value, it began to de- cline in 3 hours group, and it reached the lowest point in 24 hours group. Compared with the model 3 hours group, 6 hours group, and 24hours group, the level of CH50 in model 1 hour group increased more signifi- cantly （ respectively P 〈 0.05 ）. A small amount of C5b-9 in the normal group was detected. In the model 1 h group, C5b-9 increased significantly and reach the peak compared with 3hours group, 6hours group and 24 hours group, respectively （ P 〈 0.05）, but in the model 3hours, it began to decline, and in 24 hours group, it reduced to minimum. C5a increased insignificantly in the model 3 hours group, 6 hours group and 24 hours group, and peaked in 24 hours group compared with normal group （ P 〈 0.05 ）. Aspartate aminotrans- ferase in the model 1 hour group increased significantly and peaked in 24 hours group compared with other groups （ P 〈 0.05 ）. Conclusions A large number of complements are activated in the setting of hemor- rhagic shock. C5b-9 and CHS0 increase significantly in the early stage, and C5a. increases significantly inthe later stage. C5b-9 can be considered as an initiative factor of liver injury. The low levels of C5a in the early stage may be a mechanism of self-protection of the body. The high levels of C5a in the later stage may be a kind of decompensation, and C5a can be used as a late predictor of disease severity.