人工肝治疗前后实验性急性肝衰竭动物细胞因子变化的研究

The changes of cytokines after artificial liver therapy for animal model with acute hepatic failure

目的探讨人工肝血浆置换联合血液滤过治疗前后对急性肝衰竭动物细胞因子变化的影响。方法28头中国实验小型猪随机分为对照组(n=13)和治疗组(n=15),在给予1.2g/kg的D-氨基半乳糖后48h,治疗组进行血浆置换联合血液滤过治疗,对照组未进行任何治疗。观察比较治疗前后两组动物细胞因子的变化。结果在经过人工肝治疗后,治疗组的生存时间(128.7±11.3)h较对照组(67.9±9.4)h明显延长(t=15.9,P<0.01)。肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)均出现暂时性下降,同一时间点与对照组相比差异有显著性(t=1.9～4.7,P<0.05)。结论1次人工肝治疗可以使炎性细胞因子暂时下降,缓解急性肝衰竭的进程,但尚不能完全阻断病情的进展。

Objective To evaluate the changes of cytokines before and after plasma exchange （PE） plus continuous hemofiltration （CHE） therapy （artificial liver therapy） for large animal model of acute hepatic failure induced by D-galactosamine. Methods Furty-eight pigs were divided into two groups at random： Control group （n=13） and treatment group （n=15）. All of the animals were induced fulminant hepatic failure with administration of D-galactosamine firstly. 48 hours later the treatment group was treated with PE combined with CHF for 12 hours. Efficacy was assessed by comparing the survival time, biochemical parameters and cytokines. Results The treatment group＇s mean survival time was （128.7 ± 11.3） hours, which was much longer than that in the control group（67.9±9. 4） hours（t =15. 9, P 〈0. 01）. There were significant differences for serum cytokines of tumor necrosis factor-α （TNF-α）, interleulin-8 （IL-8） and IL-6 between the two groups at the same time（t =1.9-4. 7, P 〈0.05）. Conclusion Combined non bioartificial liver （PE plus CHF）was effective for acute hepatic failure, and may be as a good bridge therapy for liver transplantation and other treatments.