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不同时间血液灌流对脓毒症兔血IL-6及TNFα的影响
作者:纪国业 王斌 杜江  
单位:广州南方医科大学珠江医院儿科
关键词:血液灌流 脓毒症 白介素6 肿瘤坏死因子α 
分类号:
出版年·卷·期(页码):2011·39·第二期(129-133)
摘要:

[目的]:通过动态检测血IL-6及TNF-α浓度变化,探讨脓毒症兔行血液灌流最佳时机。[方法]:18只新西兰大白兔随机分成6组,通过盲肠结扎穿孔法制作脓毒症模型,分别在术后3小时、6小时、12小时、24小时、48小时行单次血液灌流,同时设立空灌流组(对照组),并都分别在手术前,术后3小时、6小时、9小时、12小时、24小时、48小时动态检测血清中IL-6及TNF-α浓度,并分别绘制变化曲线,记录各兔子生存时间。[结果]:术后12小时行血液灌流组血IL-6平均浓度最低,生存时间最长(P均<0.05);而术后3小时行血液灌流组血TNF-α平均浓度最低(P<0.05),并使TNF-α峰值降低,但生存时间较对照组未见延长。[结论]:血液灌流选择在兔脓毒症进展的早期(术后3小时)及中期(术后12小时),能分别最有效降低实验兔血前炎症介质TNF-α及IL-6浓度;且在兔脓毒症进展的中期(术后12小时)血液灌流,使实验兔生存时间最长,对临床血液灌流时机的选择有指导意义。

To investigate the best timing to be treated with hemoperfusion for sepsis rabbits by detecting the dynamic concentrations of IL6 and TNFα. Methods: 18 rabbits were randomly divided into 6 groups. They were treated with hemoperfusion once respectively in 3 hours, 6 hours, 12 hours, 24 hours, 48 hours after the cecal ligature and puncture surgery, accompanied the establishment of air perfusion group (control group). The blood concentration of IL6 and TNF-α were dynamically respectively detected before the surgery, after 3 hours, 6 hours, 9 hours, 12 hours, 24 hours, 48 hours. Then we drawn the curves and noted down the rabbit survival time. Results: The average concentration of blood IL6 in 12 hours’ hemoperfusion group was the lowest, accompanying the longest survival time (P<0.05); Nevertheless, The average concentration of blood TNF-αin 3 hours’ hemoperfusion group was the lowest(P<0.05), accompanying the declining of the peak, but not prolonging the survival time. Conclusion: Hemoperfusion in the early-term(3 hours) and medium-term progress of sepsis (24 hours) can separately effectively reduce the blood concentration of inflammatory mediator TNF-αand IL6, and the later one can make the experiment rabbits’ survival time longest, instructing the decision of our clinical hemoperfusion timing.

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