控制性低温对兔创伤失血性休克早期肺炎症反应的影响

Effects of controlled hypothermia on inflammatory reaction of lung after traumatic hemorrhagic shock in rabbits

目的探讨控制性低温对兔创伤失血性休克后早期肺部炎症反应和对肺组织损伤程度的影响。方法24只健康新西兰大白兔,随机分为正常对照组(C组)、常温组(N组)、浅低温组(MIH组)、中低温组(MOH组),每组6只。采用ELISA法测定肺组织匀浆上清液TNF-α、IL-6、IL-8、IL-10含量及肺水含量。结果创伤失血性休克后8h,肺组织匀浆TNF-α、IL-6、IL-8、IL-10含量均显著升高;MIH组和MOH组TNF-α含量低于N组(P<0.05),但组间差异无统计学意义;MIH组和MOH组肺组织IL-6含量显著低于N组(P<0.01);MIH组肺组织IL-8含量显著低于N组和MOH组(P<0.01),MOH组肺组织IL-8含量低于N组,但差异无统计学意义;MIH组和MOH组肺组织IL-10含量均显著低于N组。创伤失血性休克后早期总肺水含量显著升高,MIH组和MOH组总肺水含量低于N组(P<0.01)。结论不同程度的控制性低温对创伤失血性休克后早期肺促炎反应和抗炎反应均有抑制作用,对创伤失血性休克后的肺组织也有一定的保护作用。浅低温对创伤后肺组织炎症反应和抗炎反应的抑制作用强于中低温,而且其可控性强,副作用相对较少,因此,浅低温更有益于创伤失血性休克后早期肺组织的保护。

Objectives To investigate the effects of controlled hypothermia on inflammatory/ anti - inflammatory reaction of lung after traumatic hemorrhagic shock and mitigate inflammatory injury of lung. Methods Twenty - four rabbits were randomly segregated into four groups： normal control group （ group C ）, normal temperature group （ group N ）, mild hypothermia group （ group MIH ）, moderate hypothermia （ group MOH ）. The levels of tumor necrosis factorα （ TNF - α）, interleukin - 6,8,10 （ IL - 6,8, 101 in lung homogemate supematant were assayed with ELISA. Lung water content was represented by wet weight/dry weight. Results The levels TNF- α, IL- 6,8,10 in lung homogemate supematant increased striking after traumatic hemorrhagic shock. The levels of TNF - α in group MIH and MOH were lower than group N, there is no significantly difference among the groups, the levels of IL -6 in groups MIH and MOH were significantly lower than group N. the levels of IL - 8 in group MIH were significantly lower than groups N and MOH, the levels of IL - 8 in group MOH were lower than group N. The levels of IL - 10 in group MIH and MOH were significantly lower than group N. Lung water content in groups MIH and MOH were significantly less than group N after traumatic hemorrhagic shock. Conclusion Different degree controlled hypothermia can inhibit inflammatory/anti - inflammatory reaction and mitigate lung injury after traumatic hemorrhagic shock. Therefore mild hypothermia have more potent effects on inhibiting inflammatory/anti - inflammatory reaction than moderate hypothermia, and have less side - effects and is controlled easily. For those reasons, mild hypothermia is more beneficial for traumatic patients than moderate hypothermia.