烧伤感染创面细菌及内毒素的淋巴入侵途径和对局部淋巴免疫功能的影响  

作　　者：刘海鹰[1] 王坤[1] 赵焕童[1] 张林清[1] 吴学田[1] 王岐刚[1] 冯彩霞[1] 李彩虹[1] 

机构地区：[1]山东省潍坊市人民医院,261041

出　　处：《中国医药指南（学术版）》2008年第13期39-42,共4页Guide of China Medicine

摘　　要：目的通过检测绿脓杆菌感染烧伤创面引流淋巴结的绿脓杆菌和引流淋巴液的内毒素含量来研究其淋巴入侵途径,并探讨绿脓杆菌对局部淋巴免疫功能的影响。方法24只大鼠,将大鼠双侧后腿浸于99℃热水13s,造成约8%(每侧4%)全层皮肤烫伤,伤后15min,单侧后腿(随机)给予绿脓杆菌菌液0.5mL(1108cfu)皮下注射,分为烧伤+感染腿组(A组)和对侧烧伤腿组(B组),实验分为3个时间点:烧伤+感染后6h(6只)、烧伤+感染后24h(6只)、烧伤+感染后72h(6只)。C组(6只)为假烫伤组。收集双侧髂总淋巴结输出淋巴管内的淋巴液和髂总淋巴结。应用鲎试剂显色基质法检测淋巴液的内毒素水平,应用酶联免疫吸附法(ELISA)检测淋巴液TNF-α水平,应用细菌培养法检测淋巴结细菌数量,应用流式细胞术检测淋巴结CD4+、CD8+T淋巴细胞比例。结果烧伤+感染后6、24和72h,A组细菌感染率显著高于B组(P<0.01),内毒素水平,A组显著高于B组(P<0.01),淋巴结的活的绿脓杆菌数量与淋巴液的内毒素含量无相关关系(r=-0.14,P>0.05)。烧伤+感染后6、24和72小时,淋巴液TNF-α水平,A组显著高于B组(P<0.01)。烧伤+感染后6和24h,CD4+/CD8+T淋巴细胞比值,A、B两组间比较差异无显著性(P>0.05),而烧伤+感染后72小时,A组显著低于B组(P<0.05)。结论烧伤创面的绿脓杆菌和内毒素能够通过淋巴途径入侵机体,能够引起局部引流淋巴结的CD4+/CD8+T淋巴细胞比值降低,可能抑制局部免疫功能。Objective The aim of this study was to determine the lymphatic invasion route of bacteria and endotoxin of burn wound infected by pseudomonas aeruginosa and moreover, the effect of pseudomonas aeruginosa of the burn wound on the local lymphatic immune function. Methods Wistar rats were subjected to unilateral hind limb burn with infection of pseudomonas aeruginosa （burn＋infection limbs group, group A） and contralateral hind limb burn only （contrlateral limbs group, group B）. On hours 6, 24 and 72 after burn, rats were killed, lymph fluid in the efferent lymph trunk of the common iliac lymph nodes（CILN） were collected, The lymph fluid was applied for the measurement of TNF- a levels by enzyme-linked immunosorbent assay and endotoxin levels by Limulus Amebocyte Lysate test. The CILN was divided into two parts, one was for bacterial culture, another for flow cytometric analysis. Results There was a higher invasion incidence, TNF- a concentration and endotoxin concentration in the group A when compared to the group B （P〈0.01）. The CD4^＋/CD8^ T cell ratio was significantly lower on post burn wound infection hours 72 （P〈0.05）. Conclusion Bacteria and endotoxin of the burn wound can invade draining lymph node and lymph fluid and decrease CD4^＋/CD8^ T cells ratio of the draining lymph node.

关 键 词：烧伤 绿脓杆菌 淋巴液 内毒素 CD4^+/CD8^+ 

分 类 号：R644[医药卫生—外科学]