亚低温防治全身炎症反应综合征

Mild hypothermia prevents and cures systemic inflammatory response syndrome

目的 探讨亚低温能否抑制全身炎症反应综合征 (SIRS) ,从而阻止多器官功能障碍综合征 (MODS)的发生。方法 将 96只小鼠随机分成内毒素组、亚低温组、保温组及对照组。采用放射免疫法 ,分别于注射内毒素 (LPS)后 1、2、4h测定血清肿瘤坏死因子α(TNF α) ,并用免疫组化法检测4组动物 (4h)肝、肺血管内皮细胞细胞间粘附分子 1(ICAM 1)的表达情况。结果 亚低温组 1、2、4h的TNF α含量 [(2 .0± 0 .3)、(2 .1± 0 .4)、(2 .5± 0 .5 ) μg/L]显著低于内毒素组 [(4.1± 0 .4)、(4.1±0 .6 )、(3.3± 0 .5 ) μg/L](P <0 .0 1) ,而保温组与内毒素组相比 ,差异无显著意义 (P >0 .0 5 ) ;亚低温组与保温组在 1、2h时 [(2 .0± 0 .3)、(2 .1± 0 .4) μg/L ;(4.0± 0 .30 )、(3.8± 0 .4) μg/L]差异有显著意义(P <0 .0 1和 <0 .0 5 ) ,但 4h未见明显差别 [(2 .5± 0 .5 )、(2 .6± 0 .5 ) μg/L](P >0 .0 5 ) ;免疫组化显示亚低温组肝及肺微血管内皮细胞周围的ICAM 1组化染带呈弱阳性 ,内毒素与保温组呈强阳性表达。结论 亚低温有显著抑制全身炎症反应的作用。

Objective To explore the inhibiting effect of mild hypothermia on systemic inflammatory response syndrome (SIRS), thereby to prevent the occurrence of multiple organ dysfunction syndrome(MODS). Methods Ninety-six mice were randomly divided into four groups: the normal control, lipopolysaccharide (LPS), mild hypothermia and temperature preservation. By using the radio-immunity technique, the plasma levels of tumor necrosis factor-α(TNF-α) in the 4 groups of mice were measured after l, 2 and 4 hours of injection with LPS into mice. Livers and lungs of the mice were collected 4 hours after the injection of LPS for testing the expression of intercellular adhesion molecule-1(ICAM-1) in vascular endotheliocytes with the immunohistochemistry method. Results The contents of TNF-α in mild hypothermia group after 1,2 and 4 hours of LPS injections [(2.0±0.3), (2.1±0.4) and (2.5±0.5) μg/L, respectively] were significantly lower than those in LPS group [(4.1± 0.4), (4.1±0.6) and (3.3±0.5) μg/L, respectively] ( P <0.001). While there was no significant difference between LPS and temperature preservation groups ( P >0.05). There were marked differences between mild hypothermia and temperature preservation groups after 1 and 2 hours of the LPS injections[(2.0±0.3) and (2.1±0.4) μg/L vs. (4.0±0.3) and (3.8±0.4) μg/L, respectively. P <0.01 and <0.05], but no difference after 4 hours [(2.5±0.5) vs. (2.6±0.5) μg/L, P >0.05]. Immunohistochemistry staining showed that the expression of ICAM-1 surrounding the vascular endotheliocyte of the liver and lung was weakly positive in the mild hypothermia group, but strongly positive in the LPS group and temperature preservation group. Conclusion Mild hypothermia revealed a function of inhibiting SIRS. It suggested that mild hypothermia may be a new method for preventing and curing SIRS.