糖皮质激素对重症肺炎模型细胞因子的干预作用

Intervention effects of glucocorticoid on cytokines in severe pneumonia models

目的:探讨糖皮质激素对细菌性重症肺炎模型细胞因子的干预作用。方法:SD大鼠随机分为模型组、干预组和对照组,每组分为3小组,前2组每小组各8只,对照组每小组各4只。其中,模型组和干预组接种相同浓度、相同剂量的肺炎克雷伯菌菌液。对照组接种剂量相同的生理盐水。干预组于接种后的第2 d起,每天每只肌注醋酸泼尼松龙0.2 mg。于接种后的第2、4、6 d分批处死动物,动态观察各组的干扰素-γ(IFN-γ)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)的变化情况。结果:模型组的IL-6、TNF-α于接种后第2、4、6 d呈逐渐升高的趋势,IFN-γ呈逐渐下降的趋势。干预组在第2 d各细胞因子与模型组比较无明显变化,于第4 d或6 d起,IL-6、TNF-α与模型组比较发生明显变化。结论:诸多细胞因子可能参与重症肺炎发病的病理、生理过程,单因素小剂量糖皮质激素能使细菌性重症肺炎模型的细胞因子发生良性转变,为主张重症肺炎使用小剂量糖皮质激素提供了理论依据。

Objective：To explore the intervention effects of glucocorticoid on cytokines in SD rat models with severe bacterial pneumonia. Methods ：60 SD rats were randomly divided into model group （n = 24 ） , intervention group （n = 24） and control group （n = 12 ） , and then each group was divided into 3 subgroups. Animals in model group and intervention group were inoculated with the same dose of klebsiella pneumoniae liquid,while the same dose of normal saline was injected in control group. Since the second day after vaccination, each rat was given 0.2 nag prednisolone acetate every day by intramuscular injection. At 2,4,6 d after vaccination ,the animals were killed in batches to observe the changes of interferon -γ （ IFN - γ）, iuterleukin - 6 （ IL - 6 ） and tumor necrosis factor - α （ TNF - α ） in each group. Results ： The levels of IL - 6 and TNF - α in model group had a gradually increasing tendency, while the level of IFN - γ had a gradually decreasing tendency at 2,4,6 d after inoculation. All cytokines in intervention group had no significant difference with those in model group at 2 d after inoculation, but since the fourth or sixth day, the levels of IL - 6 and TNF - α changed significantly compared with those in model group- All cytokines in control group didn＇t change obviously at each time point. Conclusion： Many cytokines may be involved in the pathogenesis of severe pneumonia. The single factor of low - dose glucocorticoids can make cytokines in severe bacterial pneumonia models change positively, which provides a theoretical basis for useage of low - dose glueoeorticoids in patients with severe pneumonia.