异体内皮细胞输注对脓毒症猪血流动力学、乳酸、IL-1和IL-10的影响  

Preliminary observations of the effects of heterogenous endothelial cell infusion on the haemodynamics,lactic acid,IL-1 and IL-10 of porcine sepsis models

作　　者：张家瑛[1] 平易[2] 刘骏峰[1] 丁峰[1] 梁伟民[2] 顾勇[1] 林善锬[1] 

机构地区：[1]复旦大学附属华山医院肾脏科,上海200040 [2]复旦大学附属华山医院麻醉科,上海200040

出　　处：《复旦学报（医学版）》2009年第3期317-322,共6页Fudan University Journal of Medical Sciences

基　　金：复旦大学211重点建设学科经费资助项目

摘　　要：目的观察异体内皮细胞输注对脓毒症猪血流动力学、乳酸、白介素-1(IL-1)和白介素-10(IL-10)的影响,初步探讨内皮细胞对脓毒症的治疗作用,为将来构建体外内皮细胞生物反应器提供依据。方法15头家猪随机分为对照组(5头)、激素组(5头)和激素+内皮细胞组(5头)(简称激内组)。均静滴内毒素制造脓毒症模型后,对照组不予处理,激素组给予甲基强的松龙(简称甲强龙)250mg静滴,激素+内皮细胞组静滴甲强龙250mg后给予动脉注入108数量级的内皮细胞。观察血流动力学、生化指标和炎症因子的变化。结果激素组和激内组的MAP回升幅度明显高于对照组(激素组:P=0.004;激内组:P=0.000);激内组的肺血管阻力升高幅度明显低于对照组(P=0.035),而激素组与对照组无显著性差异(P=0.346);激内组的WBC回升幅度明显高于对照组(P=0.000)和激素组(P=0.000);激素组和激内组的AST升高幅度均明显低于对照组(激素组:P=0.008;激内组:P=0.005),而激素组和激内组间无显著性差异(P=0.858);激内组的IL-10明显低于对照组(P=0.021),激素组与对照组无显著性差异(P=0.158)。结论异体内皮细胞联合激素干预猪脓毒症模型可以更明显地改善血流动力学、延缓脏器功能衰竭、调节炎症水平,提示未来构建内皮细胞生物反应器治疗脓毒症的潜在价值。Objective To observe the effects of endothelial cells on haemodynamics, lactic acid, IL-1 and IL-10 in porcine sepsis models. Methods We picked up 15 pigs and divided them into 3 groups （5 for each group） randomly： control group, glueocorticosteroid （GC） group and glucocorticosteroid plus endothelial cells（GC ＋ EC） group. Lipopolysaccharide （LPS） was given by intravenous injection in all three groups and then we gave methylprednisolone（MP） 250mg to the GC group and MP 250mg plus 108 endothelial cells via arteria to the GC ＋ EC group. The changes of haemodyanmic, biochemical and inflammatory parameters were recorded. Results The elevation of mean arterial pressure P in GC and GC＋ EC group were higher than that in the control group（GC.P= 0. 004;GC＋ EC;P= 0. 000）. The elevation of pulmonary vascular resistance in GC ＋ EC group was lower than that in the control group（P = 0. 035）, while the elevation in GC group had no significant difference with the control group （P = 0. 346）. WBC recovered sooner in GC group than in control group （P = 0. 000） or GC group （P = 0. 000）. The elevation of AST in GC group and GC＋ EC group were lower than that in the control group（GC： P= 0. 008 GC＋ EC： P= 0. 005）, but no difference was observed between GC and GC＋ EC group（P= 0. 858）. IL-10 in GC ＋ EC group was lower than that in the control group（P = 0. 021 ） while no significant difference was observed between GC and control group （P = 0. 158）. Conclusions The combination of glucooorticosteroid and endothelial cells improved haemodyanmic indexes, delayed organ failures and modulated inflammatory level. It signifies the rationality of the construction of endothelial cell assist device.

关 键 词：脓毒症 内毒素 内皮细胞 血流动力学 炎症因子 猪 

分 类 号：R631.2[医药卫生—外科学]