活性炭、大孔树脂Amberlite XAD－7血液灌流对大鼠内毒素休克的防治作用

THE THERAPEUTIC EFFECT OF REMOVING LPS,TNF,IL-1 FROM CIRCULATION BY ACTIVATED CHARCOAL,AMBERLITE XAD-7BLOOD PERFUSION ON EXPERIMENTALENDOTOXIC SHOCK PAT

观察了活性炭、大孔树脂ＡｍｂｅｒｌｉｔｅＸＡＤ－７血液灌流对大鼠内毒素休克的防治作用。表明：活性炭可显著降低大鼠血浆内毒素（ＬＰＳ）、白细胞介素１（ＩＬ－１）水平（Ｐ＜０．０１），而对肿瘤坏死因子（ＴＮＦ）的降低作用不明显。ＡｍｂｅｒｌｉｔｅＸＡＤ－７灌流组ＬＰＳ、ＩＬ－１水平与假灌流组比较无显著差异，ＴＮＦ水平明显低于假灌流组（Ｐ＜０．０５）。在开始灌流后３ｈ，两个治疗组的收缩压均较假灌流组明显改善（Ｐ＜０．０５）。并且活性炭、树脂血液灌流组存活时间与假灌流组比有显著差异（Ｐ＜０．０５）。ＬＰＳ攻击后６ｈ，活杀大鼠进行病理检查，两个治疗组肺、肠、肾、肝等脏器损害较轻。由此提示，通过体外血液灌流清除循环中致病递质可能是治疗内毒素休克的另一有价值的新途径。

The therapeutic effect of hemoperfusion with activated charcoal or Amberlite XAD-7 on endotoxicshock rat were observed.Activated charcoal absorbed LPS,IL-1 effectively,After 2 hours hemoperfusion of acti-vated charcoal,LPS,IL-1 levels were significantly lower than those in the control group(P<0.01 ),whileTNF levels had no significant difference between the two groups. No difference was found in LPS, IL-l Ievels between the Amberlite XAD-7 hemoperfusion group and control group.TNF Ievels(3640±809 U/ml)in Anber-lite XAD-7 group were significantly lower than those in the control group(4960±l400 U/m1),P<0.05.3 hours after the beginning of hemoperfusion,the systolic pressure was 7.7±0.8 kPa,8.5±1.2 kPa,8.6±1.l kPa. The difference was obvious between the two treated groups and the control group.Rats in the activated charcoal and Amberlite XAD-7 hemoperfusion group survived for 9.2±1.8,9.3±2.l hours respectively,while those in the control group survived only 7.4±1.4 hours(P<0.05).Rats were sacrificed 6 hours after administration of LPS. At neoropsy,only mild organ damages were found in the two treated groups as compared with those in the control group.It is suggested that removal of deleterious mediators from the circulation by hemoperfusion may be a new therapeutic method of endotoxic shock.