摘要
目的 证实严重烫伤大鼠TNFα基因对内毒素(LPS)刺激表达敏感性较强,以及TNFα在创伤胰岛素抵抗中的作用机制。方法 给予同剂量LPS体内注射,观察严重烫伤和正常大鼠血清TNFα及肝脏TNFα-mRNA的变化,并用TNFα单克隆抗体(TNFα-McAb)静脉注射烫伤小鼠,观察骨骼肌基础和胰岛素刺激的葡萄糖摄取量的改变。结果 同剂量的LPS刺激后,正常对照组血清TNFα及肝脏TNFαmRNA升高不显著,而严重烫伤组血清TNFα及肝脏TNFαmRNA明显升高。严重烫伤组基础葡萄糖摄取明显升高,但胰岛素依赖的葡萄糖摄取明显降低,经TNFα-McAb静脉注射治疗后,基础葡萄糖摄取量明显下降,但胰岛素刺激的葡萄糖摄取明显升高。结论 严重烫伤早期TNFα基因对LPS刺激表达敏感性增强,致使TNFα水平明显升高。血清TNFα促进骨骼肌基础葡萄糖摄取和“葡萄糖循环”,抑制胰岛素刺激的葡萄糖摄取。TNFα在创伤胰岛素抵抗中发挥始动作用。
Objective To insure the high sensitivity expression of liver TNF α gene to LPS in scalded rats and to discover the mechanism of insulin resistance in trauma Methods The changes of serum TNF α and liver TNF α mRNA in scalded and control rats treated by same dosage of LPS injection, and the changes of muscle glucose-uptake in scalded rats treated by TNF α -McAb injection were observed. Results The changing levels of serum TNF α and mRNA in scalded rats were significantly higher than that of the control rats treated by same dosage of LPS. The scalded rats represented higher level of musucle glucose-uptake and it could be reduced by TNF α-McAb in peripheral blood. The scalded rats representing a low level of musucle glucose-uptake could be induced by insulin. Conclusions The scalded rats show higher sensitivity expression of TNF α gene to LPS. Serum TNF α plays an important role on insulin resistance and 'glucose-circulation' in trauma by inhibiting the muscle glucose-uptake stimulated by insulin.
