低温对创伤失血性休克后早期炎症反应影响的研究

The effect of hypothermia on earlier inflammatory reaction after trauma hemorrhagic shock in rabbits

目的通过观察全身降温和局部降温对创伤失血性休克家兔血清IL1β、IL6、IL10、TNFα水平的影响,研究探讨全身降温和局部降温是否能抑制创伤后早期炎症反应,从而防治创伤后多器官功能衰竭综合征的发生。方法30只新西兰大白兔,随机分为正常对照组、常温组(Ⅰ组)、全身浅低温组(Ⅱ组)、全身中低温组(Ⅲ组,)、创伤局部降温组(Ⅳ组),采用ELISA法测定血清IL1β、IL6、IL10、TNFα含量。结果Ⅱ组、Ⅲ组、Ⅳ组血清IL1β、IL6、TNFα的含量低于相应相点Ⅰ组血清IL1β、IL6、TNFα的含量(除T4时相点Ⅲ、Ⅳ组血清IL6含量高于Ⅰ组血清IL6含量外);而血清IL10的含量高于相应时相点Ⅰ组血清IL10的含量。结论系统低温和创伤局部降温能抑制创伤后早期炎症因子的表达,增加抗炎因子的表达,从而抑制创伤后早期炎症反应。

Objective To investigate the effect of hypothermia on serum levels of interleukin-1β(IL-1β),IL-6,IL-10,TNF-α after trauma hemorrhagic shock in rabbits, thereby inhibiting earlier inflammatory reaction and preventing multiple organ dysfunction syndrome(MODS) after trauma hemorrhagic shock.Methods Twenty-four rabbits were randomly segregated into five groups:control group normal temperature group(groupⅠ), system mild hypothermia group(groupⅡ), system moderate hypothermia group(groupⅢ) and wound regional hypothermia group(group Ⅳ); Serum levels of IL-1β,IL-6,IL-10,TNF-α were determined with ELISA.Results Serum levels of IL-1β,IL-6, TNF-α in groupⅡ,Ⅲ,Ⅳ were lower than those in groupⅠat the same points, therefore serum IL-10 levels in group Ⅱ,Ⅲ,Ⅳwere higher than those in groupat the same points;except serum levels of IL-6 in group Ⅲ,Ⅳ were higher than those in groupⅠat T4 point.Conclusion Both systemic hypothermia and wound regional hypothermia can inhibit the expression of inflammatory factors, and stimulate the expression of anti- inflammatory factors after trauma hemorrhagic shock .