糖皮质激素对烫伤后晚期脓毒症大鼠细胞免疫功能的影响

Effect of Glucocorticoid on Cellular Immune Function of Late Sepsis Rats After Burn

目的:探讨糖皮质激素(GC)对烫伤后晚期脓毒症大鼠细胞免疫功能的影响。方法:48只健康雄性的SD大鼠随机分为脓毒症组(非GC组,24只)、脓毒症糖皮质激素干预组(GC组,24只);每组平均分为1d、10d两亚组。脓毒症组大鼠背部用沸水制造体表面积30%的Ⅲ度烫伤,12h后腹腔注射5mg/kg的内毒素造模。糖皮质激素干预组应用氢化可的松(10mg/kg)于脓毒症造模成功后即刻胃管内注入;脓毒症组以生理盐水替代氢化可的松(10mg/kg)经胃管注入。应用流式细胞仪检测各组大鼠外周血中CD3+、CD4+、CD8+、CD11、CD95、CD95L及NK细胞分别占淋巴细胞的百分比;应用放射免疫方法检测各组大鼠血中皮质醇水平。结果:脓毒症时,CD8+和CD95细胞计数明显下降(P<0.05)。CD3+细胞计数在GC 10d组较1d组明显上升(P<0.01),CD4+、CD8+细胞计数在GC 10d组较1d组明显下降(P<0.01);CD3+细胞计数在GC 1d组、GC 10d组较非GC 1d组、非GC10d组明显下降;CD11b细胞计数在GC 1d组较非GC 1d组明显下降,CD95L细胞计数在GC 1d组、GC 10d组较非GC 1d组、非GC 10d组明显上升;GC组10d亚组皮质醇激素水平较1d组明显下降(P<0.01)。结论:糖皮质激素会抑制脓毒症时机体的细胞免疫状态。

Objective： To investigate the effect of glucocorticoid（GC） on cellular immune function of late sepsis rats after burn. Methods： A total of 48 healthy male SD rats were randomly divided into sepsis group （non-GC group） and sepsis plus glucoeorticoid intervention group （GC group）; Then each group was further randomized into 1 d and 10 d subgroups according to different time points. The sepsis rat model was established by intraperitoneal injection of endotoxin Ol11：B4 after 30＋ body surface area Ⅲ degree burns on the back by immerse into boiled water for 12 sec- onds. GC intervention group received intraperitoneal injection of hydrocortisone （10 mg/kg）while sepsis group used saline instead. CD3＋ , CD4＋ , CD8＋ , CDll, CD95, CD95L and NK cells in the lymphocytes in peripheral blood were detected by flow cytometer. Radioimmunoassay （RIA） was used to detect the levels of cortisol in the blood of rats in each group. Results： CD8＋ and CD95 cell counts in sepsis group was decreased significantly （P〈0.05）. CD3＋ cell count in GC 10 d group was significantly increased compared with that in 1 d group （P〈0.01）, CD4＋ and CD8＋ cell count in GC 10 d group was significantly decreased compared with that respectively in 1 d group （P〈0.01） ; CD3＋ cell count in the GC 1 d group and GC 10 d group was higher than in non-GC groups; CDllh cell count in GC 1 d group was decreased compared with that in non-GC 1 d group, CD95L cell count in the GC 1 d group was higher than in GC 10 d group and non-GC 1 d group; cortex in the GC 10 d group was significant decreased compared with that in GC 1 d group. Conclusion： Glucocorticoids may suppress cellular immune function in sepsis.