脓毒症早期外周血细胞因子的变化与意义

Changes of peripheral blood cytokines at early phase of sepsis

目的 :探讨脓毒症早期外周血细胞因子变化的规律与意义。方法 :应用盲肠结扎穿孔 (CLP)复制脓毒症的病理模型 ,观察CLP后外周血细胞因子TNF α、IL 1β、IL 6、IL 10变化和心、肝、肺、肾功能及形态学损伤。结果 :在CLP模型上 ,血中TNF α浓度 3h开始升高 ,6h达到峰值水平 ;血清IL 1β水平 6h开始显著增高 ,2 4h达到峰值水平 ;血清IL 6水平 3h显著高于对照水平 ,12h达到峰值状态 ,至 72h显著低于对照水平 ;抗炎细胞因子IL 10在 2 4h开始显著高于对照值 ,4 8h达到峰值水平 ,至 72h恢复到对照水平 ;心、肾功能在 12h和肝功能于 2 4h出现显著改变。结论 :脓毒症早期存在外周血促炎细胞因子表达上调 。

Objective: To investigate the changes of peripheral blood cytokines at early phase of sepsis and its significance. Methods: The model of sepsis was established by cecal ligation and puncture(CLP) in rats. The cytokines including serum TNF - α,IL - 1β,IL - 6,IL - 10, and some functional parameters of heart, liver and kidneys of these rats were examined at different time after CLP. Their pathological changes of heart, liver, lungs and kidneys were observed under light microscope. Results: In CLP rats, the TNF - α increased within 3 h and reached peak at 6th h. IL - 1β began to increase at 6th and reached peak at 24th h, and then restored to the control level. The level of IL - 6 was higher significantly than that of the control at 3rd h, and it reached peak at 12th h and then returned to the control level at 72nd h. The level of IL - 10, an anti - inflammatory cytokine, began to increase at 24th h, reached peak at 48th h and returned to the control at 72nd h. The levels of serum LDH, GOT, BDH, UN and CK increased significantly at 12th h, and the biochemical parameters of hepatic function increased significantly at 24th h. Conclusion: The changes of these serum cytokines at early phase of sepsis indicate the overexpression of pro - inflammatory cytokines in the body. The multiple organ dysfunction syndrome may be associated with the unbalance of these cytokine expressions.