限制性液体复苏对创伤失血性休克患者外周血单个核细胞中NF-κB基因表达的影响

Effects of Limited Fluid Resuscitation on the Activity and Gene Expression of Nuclear Factor-κB in Peripheral Blood Mononuclear Cells in Patients with Trauma Hemorrhagic Shock

【目的】研究限制性液体复苏对失血性休克患者外周血单个核细胞(PBMC)中NF-κB活性及基因表达的影响。【方法】选取创伤失血性休克患者180例,随机分为快速大量液体复苏组(A组)和限制性液体复苏组(B组),每组90例,另选择30例健康志愿者作为对照组(C组)。A组在创伤出血性休克出血未控制前进行充分的液体复苏,B组在创伤出血性休克出血未控制前行限制性液体复苏。采用酶联免疫吸附法(ELISA)检测患者PBMC中NF-κB活性,并采用RT-PCR检测NF-κB mRNA的表达。【结果】B组在入院后60 min和入院后120 min PBMC中NF-κB的活性及mRNA的表达都显著低于A组。【结论】限制性液体复苏可有效降低失血性休克患者外周血PBMC中NF-κB的活性及mRNA的表达,抑制炎症反应。

[Objective]To investigate the effects of limited fluid resuscitation on the activity and gene expression of nuclear factor-κB （NF-κB） in peripheral blood mononuciear cells（PBMC） in patients with trauma hemorrhagic shock. [Methods] A total of 180 patients with trauma hemorrhagic shock were randomly divided into limited fluid resuscitation group（ n = 90） and large quantity fluid rapid resuscitation group（ n = 90）, in addition, 30 healthy volunteers as healthy volunteers group（ n = 30）. The activity of NF-κB in PBMC was assessed with enzyme-linked immunosorbent assay （ELISA）, the mRNA expression was assessed with RT- PCR. [Results] Compared with large quantity fluid rapid resuscitation group, the activity and mRNA expression of NF-κB in PBMC were significantly decreased in limited fluid resuscitation group at the time of 60min and 120min after in-hospital. [Conclusion] Limited fluid resuscitation can decrease the activity and gene expression of nuclear factor-κB in peripheral blood mononuclear cells and inhibit the proceeding of inflammation reaction in patients with trauma hemorrhagic shock effectively.