大鼠多器官功能障碍综合征时sTNFR的变化及其意义

Change of serum soluble tumor necrosis factor receptor in rats with multiple organ dysfunction syndrome(MODS) and its clinical implication

目的 :研究大鼠多器官功能障碍综合征 (MODS)时可溶性肿瘤坏死因子受体 (s TNFR)的变化及其意义。方法 :采用创伤 +感染 2次打击 ,复制了“双相迟发”的 MODS大鼠模型 ;应用 EL ISA方法 ,检测血清中 s TNFR浓度的变化。结果 :实验模型组 (A组 ) MODS后血清 s TNFR 的浓度为 (438.0 6± 6 7.0 6 ) pg/ m l,较正常水平 [(112 .15± 2 4 .95 ) pg/ ml]显著增高 (P<0 .0 1)。仅受感染或创伤 1次打击的两对照组 (B组和 C组 )处死前 s TNFR 改变不明显。 A组中功能障碍器官数 =2或 >2的大鼠 s TNFR 分别为 (35 8.6 3± 17.0 8) pg/ ml和 (474 .18± 4 7.2 5 ) pg/ ml(P <0 .0 1) ,且与 AL T升高呈正相关 (r=0 .95 0 0 )。3组动物 s TNFR 变化均不甚明显。 结论 :大鼠 MODS时 s TNFR 升高明显 ,且与多器官功能障碍程度呈正相关。提示监测血 s TNFR 可预测 MODS的发生 ,外源性 s TNFR治疗 MODS可能有一定的应用前景。

Objective: To investigate the changes of sTNFR in rats with MODS and its clinical implication. Methods: Rat delayed two phase models of MODS were replicated, then serum sTNFR were measured respectively pre and post MODS by ELISA method. Results: Serum sTNFRⅠ pre and post MODS was (112.15±24.95) pg/ml and (438.06± 67.06) pg/ml ( P <0.01). There was no significant difference between the levels of sTNFRⅡpre and post MODS in 3 groups. Conclusion: Our results demonstrate that serum sTNFRⅠis increased in the process of MODS, TNF induced SIRS (systemic inflammatory response syndrome) can be partly reduced. sTNFRⅠ may be a parameter in predicting MODS and is useful in clinical treatment.