创伤患者p38MAPK活化和炎症因子表达的变化  

Changes of the activation of p38MAPK and the expression of inflammatory cytokines in traumatic patients

作　　者：王毅鑫[1] 苏文利[1] 杨兴易[2] 朱文献[1] 金戈[1] 陈奋[1] 潘剑峰[1] 刘宇健[3] 李忆东[3] 

机构地区：[1]上海中医药大学附属普陀医院急救中心,200062 [2]解放军第二军医大学附属长征医院急诊科, 上海200433 [3]解放军第二军医大学病理生理学教研室

出　　处：《中国急救医学》2008年第5期399-402,共4页Chinese Journal of Critical Care Medicine

基　　金：上海市卫生局医学重点专科主攻课题(No05110182-1)

摘　　要：目的探讨不同创伤程度患者体内p38MAPK活化和炎症因子表达的变化及其意义。方法不同创伤程度患者在创伤后6h内和第1、3和7天分别采集外周血,采用蛋白免疫印迹法(Western-blot)检测白细胞中p38MAPK的活化(磷酸化)水平,采用酶联免疫吸附法(ELISA)测定血液中TNFα和IL-6水平。结果创伤6h内患者血液中p38MAPK的活化水平与正常人比较显著增加且达到高峰(P<0.01),并持续活化至第7天(P<0.05);创伤患者体内的TNFα和IL-6水平也显著增强(P<0.05),且都在创伤后第1天达到高峰(P<0.01),随后逐渐下降,在创伤后第7天逐渐恢复至正常水平(P>0.05);p38MAPK的活化程度及TNFα、IL-6水平都随创伤程度的增加而升高(P<0.05),p38MAPK的活化水平与TNFα、IL-6水平呈正相关(P<0.05),TNFα水平与IL-6水平也呈正相关(P<0.05)。结论创伤患者体内的p38MAPK信号通路被激活,p38MAPK活化引起炎症因子表达升高,表明p38MAPK信号通路在创伤后的炎症反应中发挥重要作用。Objective To investigate the activation of p38MAPK and the expression of inflammatory cytokines in traumatic patients and their significance. Methods Peripheral blood samples were collected from traumatic patients at 6 hours and 1,3,7 days after trauma, respectively. Western - blot was used to examine the activation （phosphorylation） of p38MAPK, the level of TNF-α and IL- 6 were measured by ELISA. Results Compared with healthy controls, the activation of p38MAPK was increased and rose to peak in traumatic patients at 6 hours after injury （ P 〈 0.01 ）, and kept at high level until 7 days （ P 〈 0. 05 ）. The level of TNF-α and IL - 6 were also increased and rose to peak in traumatic patients at 1 day after injury （ P 〈 0.01 ）, then decreased gradually and returned to the normal level at 7 day （ P 〉 0. 05）. Furthermore, the activation of p38MAPK as well as the level of TNF- α and IL-6 were all augmented with the increase of injury severity score （ ISS ） （ P 〈 0.05 ）. There were positive correlations between p38MAPK activation and TNF - α, IL - 6 level, and between TNF - α and IL - 6 level （ P 〈 0. 05 ）. Conclusion The signal pathway of p38MAPK is activated in traumatic patients, and the activation of p38MAPK induces the increase of inflammatory cytokines, which indicates that p38MAPK may play an important role in the inflammatory reaction after trauma.

关 键 词：创伤 信号通路 丝裂原活化蛋白激酶 炎症 炎症因子 

分 类 号：R641[医药卫生—外科学]