下肢枪弹伤感染继发DIC中IL-10及其抗体的作用  

Effect of IL-10 on DIC induced by gunshot wounds combined with infection

作　　者：王玮[1] 林国强[1] 李楠楠[1] 杜艳[1] 

机构地区：[1]解放军175医院血液科,福建漳州363000

出　　处：《东南国防医药》2011年第3期193-196,共4页Military Medical Journal of Southeast China

基　　金：南京军区"十一五"课题(06MA94);福建省青年人才基金资助(2006F3149)

摘　　要：目的研究在下肢枪弹伤后感染继发弥散性血管内凝血(disseminated intravascular coagu-lation,DIC)过程中白细胞介素10(interleukin-10,IL-10)所起作用,并尝试应用IL-10及其抗体在DIC不同发展过程中进行防治。方法以7.62 mm枪弹击伤家兔后肢后,经耳缘静脉滴注内毒素(LPS),分别在不同时间检测凝血功能、血小板、D-二聚体等DIC指标,按DIC诊断标准建立模型。同时检测IL-10等因子水平,以了解IL-10在DIC发展中的作用;通过在DIC不同阶段进行IL-10或抗IL-10抗体治疗,检测肿瘤坏死因子-α(TNF-α)、白细胞介素1(IL-1)等促炎因子、DIC指标的变化,了解IL-10或IL-10抗体在防治下肢枪弹伤后感染继发DIC中作用。结果单纯枪弹伤组及对照组各项指标均未达到DIC标准,枪弹伤合并感染组以及单纯感染组,静脉滴注LPS后6~24 h其活化部分凝血活酶时间(APTT)较对照组、单纯枪弹伤组明显延长,血小板值随时间延长而呈下降趋势,D-二聚体持续阳性,且随时间延长,数值呈逐渐增高趋势,均达到DIC诊断标准;枪弹伤合并感染组与对照组...Objective To explore the effect of IL-10 on prevention and treatment of DIC induced by gunshot wounds combined with infection.Methods After the rabbit model of DIC with gunshot wounds and infection was constructed,PT,APTT,FIB,PLT and D-dimer of the rabbits were tested by Diagnostic Satgo SAS and the level of IL-10 were tested by ElISA(enzyme linked immunosorbent assay) in the different time.When IL-10 or anti-IL-10 antibody were used to treat DIC in the different phase,the level of TNF-α,IL-1 or the different diagnose index of DIC were tested to elucidate the function of IL-10 in prevention and treatment of DIC.Results APTT of rabbit with DIC and infection effected by gunshot wounds were obviously longer than that of the control during 6-24 hours.Along with the time expanding,the value of PLT descended gradually.The value of D-dimer increased gradually.The level of IL-10 had a trend of increasing gradually within 2-6 hours and soon up to steady level.The level of TNF-α and IL-1 could be reduced by preventively using IL-10 in the prophase of DIC.The level of IL-10 could be reduced by using anti-IL-10 antibody in the developmental phase of DIC.Conclusion DIC could not be induced singly by gunshot wounds,but it easily induced by gunshot wounds with infection.In the prophase of DIC caused by gunshot wounds with infection,the level of IL-10 was lacking relatively.However,it was overabundant in the developmental phase.Maladjustment of IL-10 was one of the reasons of leading to the development of DIC.Preventive using IL-10 in the prophase of DIC or using anti-IL-10 antibody in the developmental phase of DIC maybe have positive function to treat DIC.

关 键 词：枪弹伤 感染 白细胞介素10 弥散性血管内凝血 

分 类 号：R9[医药卫生—药学]