免疫吸附抗介质治疗内毒素休克的实验研究

To Deal with Endotoxin Shock with Immunoabsorptive Antiamboceptor in Lab

目的观察应用免疫吸附的方法特异性清除循环肿瘤坏死因子－α（ＴＮＦ－α）对内毒素休克的影响。方法利用新西兰白兔内毒素休克模型，研究经抗ＴＮＦ－α单克隆抗体亲和免疫吸附柱血液灌流对平均动脉压、血浆ＴＮＦ－α活性、肝肾功能及存活率的影响。结果免疫吸附治疗后，血浆ＴＮＦ－α水平迅速下降，低血压状态明显改善，延缓和显著减轻了肝肾功能损害及心肌、细胞膜和溶酶体损伤的发生，实验动物存活率明显提高。结论免疫吸附特异性清除循环ＴＮＦ－α可能是一条治疗内毒素休克的新的有效途径。

Aim To evaluate the therapeutic effect of specific removal of circulating tumor necrosis factor α (TNF α) by immunoabsorption in endotoxin shock. Methods Some New Zealand white rabbits were injected intravenously with Lipopolysaccharide (LPS, Escherichia coli O 111 :B 4 8.0×10 9 cfu/kg.B.W) and underwent hemoperfusion through the immunoabsorbent colums against TNF α at 1 hour after being injected with LPS. The mean arterial pressure (MAP), plasma levels of TNF α, serum levels of alanine transaminase (ALT), aspartate transaminase (AST), lactate dehydrogenase (LDH), alpha hydrobulyric dehydrogenase (HBDH) and alkaline phosphatase (AKP), as well as blood urea nitrogen (BUN) and creatinine (Cr) were detected. The survival rate of rabbits at 24 hours was observed, too. Results Immunoabsorption could remove the circulating TNF α rapidly and effectively, raise MAP significantly, ameliorate the LPS induced renal dysfunction, and delay and attenuate the injury of liver, myocardium, cellular membranes and lysosomes in endotoxin shock. Moreover, the survival rate of rabbits at 24 hours increased, too. Conclusion Specific removal of circulating TNF α by immunoabsorption may be a new and effective therapy for endotoxin shock.