早期持续血液净化对猪创伤性多器官功能障碍综合征细胞因子和预后的影响

Effects of early continuous blood purification in traumatic pigs with multiple organ dysfunction syndrome.

目的:探讨早期持续血液净化(CBP)对猪创伤性多器官功能障碍综合征(MODS)细胞因子和预后的影响。方法:健康雄性小型猪13只,分为对照组(n=7)和实验组(n=6),实施二次打击建立MODS模型,实验组在对照组治疗基础上加用CBP治疗,监测实验动物心率、平均动脉压、氧合指数和检测肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)和血管内皮生长因子(VEGF)。结果:实验组动物CBP治疗后心率、平均动脉压和氧合指数较对照组有显著性改善(P<0.05),TNF-α、IL-6水平分别为(173.37±15.64)pg/mL、(146.46±79.64)pg/mL,较对照组的(198.81±17.07)pg/mL、(183.38±103.47)pg/mL降低(P<0.05),而VEGF水平为(29.66±2.26)pg/mL,较对照组的(18.55±3.53)pg/mL升高(P<0.05);实验组动物生存率(83%)高于对照组(29%)(P<0.05)。结论:早期应用CBP技术,可以降低血中炎症细胞因子水平,减弱炎症反应,有利于VEGF的表达,降低创伤引起MODS的病死率。

Objective To study the effect of early continuous blood purilication（CBP） in traumatic pigs with multiple organ dysfunction syndrome. Methods 13 pigs were divided into control group（n = 7） and experimental group （n = 6）. All animals were treated with ＂a second hit＂ to establish MODS models. Animals in experimental group were treated with CBP. The mean arterial blood pressure, heart rate and oxygenation index of all animals were monitored and the serum tumor necrosis factor-α （TNF-α）, interleukin-6 （IL-6） and vascular endothelial growth factor （VEGF） were detected . Results There were remarkable improvement in mean arterial blood pressure, heart rate and oxygenation index in experimental group （P 〈 0.05）. By the end of CBP, the serum TNF-α and IL-6 in experimental group were （173.37 ± 15.64）pg/mL and （146.46 ± 79.64）pg/mL respectively,which were lower than those in control group （P 〈 0.05）. But the serum VEGF in experimental group [ （29.66 ± 2.26）pg/mL] was higher than those in control gronp（P 〈 0.05）. The survival rate in experimental group was 83% while that in control group was 29%. Conclusion Early CBP can decrease the level of the serum TNF-α and IL-6 and improve the level of the serum VEGF. These may be beneficial to decrease the mortality of MODS.