老年大鼠髋部骨折愈合过程中血清炎性因子TNF-α和IL-10含量的变化

Changes of serum inflammatory cytokines TNF-α and IL-10 in the healing of hip fracture in aged rats

目的探讨老年大鼠髋部骨折后72 h内血清TNF-α和IL-10的变化规律。方法 SD大鼠75只,15只作为对照组,60只建立老年大鼠髋部骨折模型(实验组)。分别测定骨折后24 h、48 h和72 h的血清IL-10和TNF-α值。结果骨折后大鼠血清TNF-α和IL-10含量升高,24 h后升高最明显,随后逐渐降低。72 h后实验组大鼠死亡21只(死亡组),39只趋于愈合(愈合组)。死亡组IL-10始终处于较低水平,但TNF-α含量与愈合组比较差异无统计学意义(P>0.05),死亡组大鼠TNF-α与IL-10含量的比值明显高于愈合组和正常组,愈合组该比值在72 h后趋于正常。结论骨折愈合过程中TNF-α和IL-10含量具有一定相关性,血清IL-10含量低、TNF-α和IL-10比值升高会造成过度炎症反应。对于老年髋部骨折患者,动态监测血清TNF-α、IL-10和TNF-α/IL-10对预测预后有一定的指导意义。

Objective To investigate the changes of serum TNF-α and IL-10 in 72 h after hip fracture in aged rats.Methods Seventy-five SD rats were included in the study. Sixty rats were established as older hip fracture models（experimental group）. The other 15 rats was the normal group. The levels of IL-10 and TNF-α in rats at 24 h, 48 h and 72 h after fracture were measured. Results After fracture, serum TNF-α and IL-10 levels increased significantly. They get the maxium after 24 h, then gradually decreased. Twenty-one rats died（death group） and 39 rats tended to heal（healing group） 72 h later in the experimental group. In the death group, IL-10 was preserved at a low level, but there was no significant difference between the death group and the healing group（P〉0.05）. The ratio of TNF-α and IL-10 in the death group was significantly higher than those in the healing group and the normal group. The ratio of healing group tended to be normal after 72 h. Conclusion There is a correlation between TNF-α and IL-10 level during fracture healing. Low serum IL-10 level and high ratio of TNF-α and IL-10 will cause over-inflammation. Dynamic monitoring of serum TNF-α, IL-10 and their ratio in elderly patients with hip fracture has certain guiding significance in clinical work and prognosis.