脓毒症对膈神经电生理及TNF-α表达的影响  

The effects of sepsis on expression of electrophysiology and TNF -α in phrenic nerve

作　　者：李灵丰[1] 周青山[1] 刘培[1] 曹经山[1] 

机构地区：[1]武汉大学人民医院重症医学科,430060

出　　处：《临床外科杂志》2010年第3期198-200,共3页Journal of Clinical Surgery

摘　　要：目的探讨脓毒症对膈神经电生理及TNF-α表达的影响及两者的相关性。方法采用盲肠结扎穿刺（CLP）造成大鼠脓毒症模型，分别在6、24、72h运用电生理学方法检测膈神经传导诱发电位（CMAP），并取膈神经作TNF-α免疫组化分析。结果膈神经传导研究显示脓毒症6h组（Sep6），24h组（Sep24）与72h组（Sep72）CMAP潜伏期延长，时程增加，波幅明显减小，各组相比差异具有统计学意义（P〈0．05）；免疫组化分析显示脓毒症6h组、24h组与72h组膈神经TNF-α均呈显著表达，各组相比差异具有统计学意义（P〈0．05）。结论在脓毒症早期即有膈神经病变的存在，并且TNF-α的表达和电生理指征均随着时间变化逐渐增强，两者具有显著相关性，提示TNF-α可能对膈神经病变的发展具有调控作用。Objective To investigate the influence of sepsis on expression of TNF -α and electrophysiology, and the correlation between them in phrenic nerve. Methods By using the method of cecal ligation and puncture, the rats model of sepsis was established. Phrenic nerve conduction evoked potential was measured electrophysiologically, and phrenic nerve specimens were obtained for immunohistochemical（ICH） analysis of TNF-α at 6,24 and 72 h. Results The phrenic nerve conduction examinations revealed in sepsis 6, sepsis 24, and sepsis 72 h groups the amplitude of Phrenic nerve conduction evoked potential was decreased, and the duration and latency prolonged. Comparison among groups showed there was significant difference（ P 〈 0.05 ）. ICH analysis of TNF -α showed the sepsis 6 h, sepsis 24 h, and sepsis 72 h groups the expression of TNF-α was markedly increased in the phrenic nerve, and there was significant difference among groups （ P 〈 0.05 ）. Conclusion The phrenic neuropathy bad taken place in the early stage of sepsis. And over time, the expression of TNF -α and the electrophysiological indicators were gradually enhanced and there was a significant correlation between them, suggesting TNF -α may play an important modutory role in the development of phrenic neuropathy.

关 键 词：脓毒症 膈神经 神经病 TNF-Α 电生理 

分 类 号：R614[医药卫生—麻醉学]