生物人工肾小管对多器官功能衰竭细胞因子及存活时间的影响

Effect of bioartificial renal tubule on IL-10,TNF-áand survival time in pigs with MOF

目的研究用细胞株(LLC-PK1)构建的生物人工肾小管装置(RAD)对多器官功能衰竭(MOF)猪白介素(IL)-10、肿瘤坏死因子(TNF)α及存活时间的影响。方法ARF并MOF猪随机分为3组:(1)RAD组(A组,n=5):将RAD与血滤器相连,行连续静脉静脉血液滤过(CVVH)治疗24h;(2)假RAD组(B组,n=5):将RAD换为无细胞的假RAD,余与A组同;(3)未治疗组(C组,n=6)。观察血压、肝肾功能、血气、血IL-10、TNF-α(用特异性猪IL-10、TNF-α抗体检测)和生存时间。结果(1)A组治疗24h低血压状况显著改善;4～20h精神状态明显好转。(2)血IL-10(pg/ml)的峰值A组明显高于B、C组(241.40±86.64比106.30±9.69、102.59±10.21,P<0.05)。(3)血TNF-α(pg/ml)A组治疗后较治疗前明显降低(415.30±34.83比526.67±40.08,P<0.05);B、C两组无明显变化。(4)A组生存时间为(110.25±18.69)h,明显长于B组(81.20±11.76)h和C组(74.96±23.00)h(P<0.05),A组比B、C组分别延长了35.8%、47.1%。结论用RAD治疗明显改善了MOF猪低血压,升高血IL-10、降低TNF-α及延长存活时间。

Objective To investigate the effect of bioartificial renal tubul e assist device(RAD) on IL-10,TNF-á, biochemistry indexes, and survival time in pigs with multiple organ failure(MOF). Methods Pigs suffered from ARF and MOF w ere treated with RAD(A group,n=5) or sham RAD containing no cells(B group,n=5) o r received no treatment(C group,n=6). Blood pressure,hepatic and renal function, IL-10,TNF-á,arterial blood gas and survival time of all three groups were re corded periodically. Results (1)MAP responed more rapidly and reached higher val ues in group A compared to group B or C after 24 hours of the treatment. (2)The peak level of serum IL-10 in group A was significantly higher than those in gro up B or group C(241.40±86.64 vs 106.30±9.69 or 102.59±10.21,pg/ml,P< 0.05). ( 3)Serum TNF-álevel in group A dropped gradually to (415.30 after 24 hours, and had significant discrepancy compared to those before treatment [( 526.67±40.08)pg/ml] and those in group B(P< 0.05). (4)The average survival tim e in group A was significantly longer [(110.25±18.69)h] than that in the group B[(81.20±11.76)h] or group C[(74.96±23.00)h](P< 0.05),which was prolonged by 3 5.8%and 47.1%,respectively. Conclusion Treatment with RAD can prolong the surv ival time of MOF,possibly through increasing the level of IL-10 and decreasing the level of TNF-á.