抗TNF抗体防治腹腔感染诱发多器官功能障碍综合征的作用

The role of anti-tumor necrosis factor antibody in the treatment of multiple organ dysfunction syndrome induced by intra-abdominal infection

目的：实验观察抗TNF抗体防治腹腔感染(IAI)诱发多器官功能障碍综合征(MODS)的作用. 方法：按照制作IAI诱发MODS动物模型的方法,将20只兔行盲肠结扎加穿孔(CLP),并随机分成两组.抗TNF抗体组在CLP后0.5 h给予抗TNF血清2.5 ml/kg(每微升能中和TNF活性1 000 U)；对照组给予非免疫血清2.5 ml/kg,实验观察1周.测血清细胞因子(TNF、IL-6)、血气分析(PaO2,PaCO2)、血清生化(ALT、AST、CPK、CRE)和直肠温度的变化,在动物死亡或观察1周结束处死时,取血液作细菌培养和取心、肺、肝、肾、小肠等脏器作病理检查,并比较两组动物的生存率. 结果：与对照组相比,应用抗TNF抗体组直肠温度降低,血清TNF和IL-6水平下降,血气分析和血清生化指标改善,器官病理改变减轻,生存率显著提高.

Objectives:To observe the role of antibody raised against tumor necrosis factor(TNF) in the treatment of multiple organ dysfunction syndr ome(MODS) induced by intra-abdominal infection(IAI). Methods:Twent y rabbits with cecal ligation plus puncture(CLP) were randomly divided into two g roups,one receiving the anti-TNF serum(anti-TNF antibody group) and another re ce iving the non-specific serum(control group) at 0.5 h after CLP.The animals were placed in metabolic cages and maintained with infusion for one week of observati on.Levels of serum TNF and IL-6,arterial blood gas analysis(PaO2,PaCO2),bio c hemical indexes(ALT,AST,CPK,CRE) and rectal temperature were determined dynamica lly.The death of animals was also recorded.Blood bacterial culture and pathologi cal examination of organs were made when the animal was dead or sacrificed at th e end of observation period. Results:Compared with the control grou p,the levels of TNF and IL-6 were significantly decreased. The abnormal changes of blood gas analysis and biochemical determination were significantly attenuate d. The increase of rectal temperatures was obviously lowered.The pathological in juries of organs were markedly improved and the survival rate was significantly increased in anti-TNF antibody group. Conclusions:Anti-TNF antibo dy is beneficial in treating severe IAI and MODS.