抗肿瘤坏死因子单克隆抗体对兔创伤性急性呼吸窘迫综合征的保护作用

The protective effect of tumor necrosis factor monoclonal antibody on traumatic acute respiratory dis-tress syndrome in rabbit

目的探讨创伤伴感染时肿瘤坏死因子(TNF)和白细胞介素8(IL-8)在急性呼吸窘迫综合征(ARDS)中的作用及抗TNF单抗(TNF-MAb)的保护效果。方法通过胸部创伤加静注脂多糖(LPS),在建立兔ARDS模型中静注TNF-MAb。结果模型组PaO_2下降,两肺出血水肿,血浆和支气管肺泡灌洗液中TNF和IL-8升高,心、肝、肾组织有炎性改变。治疗组TNF和IL-8峰值下降,肺、心、肝、肾组织病理变化减轻。结论 TNF和IL-8参与了创伤性ARDS发病过程。ARDS不是单一的肺损伤,而是多器官衰竭(MOF)的一个重要组成部分。TNF-MAb对ARDS具有良好的保护作用。

Objective To investigate the role of tumor necrosis factor and IL-8 in the pathogenesis of acute\respiratory distress syndrome and protective effects of TNF monoclonal antibody during the period of trauma with infection. Methods A model of ARDS was established by thoracic trauma and intravenous injection of lipopolysaeharide in rabbits. The ARDS rabbits received the intravenous injection of TNF-McAb. Results In the model group, a decrease of PaO_2, pulmonary hemorrhage and edema were found. The contents of TNF and IL-8 in plasma and brochoalveolar lavage fluid were higher and the pathologi-cal damage more severe in group C than those in other groups. Inflammatory reaction of the heart, liver and kidney of the rabbits also appeared in group C. The decrease of the peak value of TNF and IL-8 was significant in the group of treatment. There were less severe pathological changes of lung, heart, liver and kidney tissues in group D. Conclusion TNF and IL-8 might take part in the development of trau-matic ARDS. ARDS might not only be a lung injury but also an important part of multiple organ failure. TNF-McAb could have a protective effect on ARDS.