循环内皮细胞与TNF-α和IL-6在MODS中相关性变化的研究

Study on the correlation of CEC,TNF-α,IL-6 in MODS

目的探讨失血性休克合并内毒素血症"二次打击"致多器官功能衰竭(multiple organ dysfunctionsyndrome,MODS)时兔循环内皮细胞(CEC)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、血气指标的变化及其相关性。方法选择新西兰兔24只,随机分为对照组、休克组、MODS组3组,每组8只。休克组给予股动脉放血,1h后回输。MODS组于回输后腹腔注射内毒素。对照组给予腹腔注射生理盐水。48h后取静脉血检测CEC的含量及各组血清IL-6及TNF-α的浓度,取动脉血测定各组pH值、氧分压(PO2)和二氧化碳分压(PaCO2)。结果 MODS组中CEC的含量、IL-6和TNF-α的浓度均高于对照组和休克组(P<0.05),MODS组中pH值和PaCO2下降幅度也较对照组和休克组明显。相关性分析显示,CEC与血清IL-6和TNF-α的浓度呈正相关性(r=0.538,0.627),与PaCO2的改变呈负相关(r=-0.543)。结论 "二次打击"致MODS时血管内皮细胞损伤与炎症因子的释放和血气指标的变化具有一定的相关性。

Objective To investigate the change and correlation between circulating endothelial cells （CEC） and tumor necrosis factor-α（TNF-α）, Interleukin-6 （IL-6）, blood gas index in multiple organ dysfunction score （MODS） was made by ＂two-hit＂ which of hemorrhagic shock combine with endotoxemia. Methods Twenty-four healthy rabbits were randomly divided into 3 groups （n =8）： control group, hemorrhagic shock group, MODS group. The rabbits were drawn blood from femoral artery and transfused after 1 h in shock group. The rabbits were injected endotoxin into abdominal cavity after that in MODS group. 48 hours later,some indexes were measured, including CEC, TNF-α, IL-6 and pH, PaCO~, PO2. Results