黄芪多糖和布洛芬联合治疗创伤感染的研究──对巨噬细胞功能的恢复作用

Experimental Treatment of Traumatic Infection by Using Astragalus Polysaccharides and Ibuprofen

巨噬细胞功能异常是创伤感染发生的重要机制。笔者观察创伤感染小鼠腹腔巨噬细胞吞噬功能和分泌ＰＧＥ２、ＴＮＦ和ＩＬ－１能力的变化，以及免疫激活剂黄芪多糖和环氧化酶抑制剂布洛芬对动物存活率与巨噬细胞功能的影响。结果表明：小鼠双股骨骨折后２４小时接受活绿脓杆菌注射，腹腔巨噬细胞吞噬发光强度明显降低，而ＰＧＥ２、ＴＮＦ和ＩＬ－１的分泌却明显增多。黄芪多糖和布活芬及合用抗生素均未能明显提高创伤感染小鼠的存活率。黄芪多糖明显增强巨噬细胞吞噬发光强度，并抑制ＰＧＥ２的释放，但进一步促进ＴＮＦ的释放。布洛芬则明显抑制ＰＧＥ２和ＴＮＦ的释放，对吞噬功能无明显影响。黄芪多糖和布洛芬联合用于创伤感染的治疗，既增强了巨噬细胞吞噬发光强度，又明显抑制了ＰＧＥ２、ＴＮＦ和ＩＬ－１的分泌。免疫激活剂和环氧化酶抑制剂的组合可望成为创伤感染药物治疗的新方案。

Macrophage dysfunction is a vital mechanism of traumatic infection. In the present study, in vitro production of PGE 2, TNF, IL 1 and chemiluminescence by peritoneal macrophages from mice traumatized by double femora fracture and complicated with live Pseudomonas aeruginosa infusion were observed, and an immune stimulator astragalus polysaccharides (APS) and a cyclooxygenase inhibitor ibuprofen (IBU) were administered to the animals to evaluate their ability to improve animal survival and macrophage functions. The results were as follows: In animals with traumatic infection, peritoneal macrophages showed an inhibition of chemiluminescence, while their in vitro production of PGE 2, TNF and IL 1 was increased markedly. Administration of APS and IBU and combined with kanamycin after bacterial challenge failed to improve 10 days survival rate. In the APS treated mice, macrophage chemiluminescence was strongly elevated, and PGE 2, and TNF release reduced significantly. In the IBU treated mice, the production of PGE 2 TNF and IL 1 was markedly inhibited, and chemiluminescence was not influenced. Combination of APS and IBU enhanced macrophage chemiluminesence and inhibited the release of PGE 2 TNF and IL 1 at the same time. In conclusion, the inhibition of macrophage phagocytosis and activation of its cytokine production plays an important role in the pathogenesis of traumatic infection. The combination of immune stimulator astragalus polysaccharides and cyclooxygenase inhibitor ibuprofen makes the pharmacological effects of the two drugs complementary, and this recipe is of great clinical implication in the management of traumatic infection.(Original article on page 356)