抗J5血清对腹腔感染伴多器官功能障碍的代谢调理

The metabolic intervention of anti J5 serum on intra abdominal infection complicated by multiple organ dysfunction syndrome

目的：观察抗内毒素核心糖脂抗体（Ｅ．ｃｏｌｉＯ１１１：Ｂ４粗糙变异株Ｊ５的免疫血清）对腹腔感染（ＩＡＩ）伴多器官功能障碍综合征（ＭＯＤＳ）的代谢调理作用。方法：将２０只采用盲肠结扎加穿孔（ＣＬＰ）方法诱发的ＩＡＩ伴ＭＯＤＳ的兔随机分成两组，在ＣＬＰ后０．５ｈ分别给予抗Ｊ５血清（Ｊ５组）和非免疫血清（对照组），动态检测了血浆内毒素、血清细胞因子（ＴＮＦ、ＩＬ－６）、激素（皮质醇、胰岛素、胰高血糖素）、血清生化指标（葡萄糖、胆固醇、甘油三酯、白蛋白）和每天尿中尿素氮、肌酐、３－甲基组氨酸排出的变化。观察时间为１周，并记录死亡情况。结果：与对照组比较，应用抗Ｊ５血清组能够明显减低血浆内毒素水平和血清ＴＮＦ、ＩＬ－６水平，减低血清皮质醇和胰高血糖素水平，抑制血清胰岛素水平的下降，血糖无明显的下降，减低胆固醇和甘油三酯升高的幅度，减低白蛋白浓度下降的幅度，减少尿中尿素氮、肌酐和３－甲基组氨酸的排出量，提高生存率。结论：抗内毒素核心糖脂抗体（抗Ｊ５血清）能够明显改善ＩＡＩ伴ＭＯＤＳ的代谢紊乱。

Objectives:To observe the effect of metabolic intervention of E.coli J5 antiserum on intra abdominal infection(IAI) complicated by multiple organ dysfunction syndrome(MODS). Methods:Twenty rabbits with cecal ligation plus puncture(CLP) induced IAI complicated by MODS were randomly divided into two groups,one receiving the antiserum raised against E.coli J5(anti J5 group) and another receiving the non specific serum (control group).Plasma endotoxin level,serum levels of TNF and IL 6,hormones (cortisol,insulin,glucagon),biochemical indexes(glucose,cholesterol,triglyceride,albumin) and daily excretions of urea nitrogen(UN),creatinine(Cr) and 3 methylhistidine(3 MH) were dynamically determined for 7 days.The death of animals was also recorded. Results:Compared with the control group,the levels of plasma endotoxin,serum TNF,IL 6,cortisol and glucagon were significantly decreased after the injection of immune serum in anti J5 group,with significant improvements of biochemical indexes and decreased excretions of UN,Cr and 3 MH in urine.The survival rate was significantly raised in the anti J5 group. Conclusions:The antibody against E.coli J5 can attenuate the metabolic abnormalities of IAI and MODS,being of the metabolic intervention on the hypercatabolism.