不同时间血液灌流对脓毒症兔血IL-6及TNF-α水平的影响  

Effect of hemoperfusion in different time on blood IL-6 and TNF-α of sepsis rabbits

作　　者：纪国业[1] 王斌[1] 杜江[1] 张建[1] 

机构地区：[1]南方医科大学珠江医院儿科,广东广州510282

出　　处：《现代医学》2011年第2期129-133,共5页Modern Medical Journal

摘　　要：目的:通过动态检测脓毒症兔血IL-6及TNF-α水平变化,探讨行血液灌流最佳时机。方法:将18只新西兰大白兔随机分成6组,通过盲肠结扎穿孔法制作脓毒症模型,分别在术后3、6、12、24、48 h行单次血液灌流,同时设立空灌流组(对照组),并均在手术前,术后3、6、9、12、24、48 h动态检测血清中IL-6及TNF-α水平,记录各组兔子的生存时间。结果:术后12 h行血液灌流组血IL-6平均水平最低(854.2 pg.ml-1),生存时间最长(73.3 h),P<0.05;而术后3 h行血液灌流组血TNF-α平均最低(68.2 pg.ml-1,P<0.05),并使TNF-α峰值降低,但生存时间较对照组未见延长。结论:血液灌流在脓毒症早中期进行,能有效降低血前炎症细胞因子TNF-α及IL-6水平,并使实验兔生存时间延长。Objective：To investigate the best timing to perform hemoperfusion for sepsis rabbits by detecting the dynamic concentrations of IL-6 and TNF-α.Methods：18 rabbits were randomly divided into 6 groups.They were treated with hemoperfusion once respectively in 3 hours,6 hours,12 hours,24 hours,48 hours after the cecal ligature and puncture surgery,control group underwent fake perfusion.The blood concentration of IL-6 and TNF-α were dynamically detected before the surgery respectively,after 3 hours,6 hours,9 hours,12 hours,24 hours,48 hours.Then we noted down the rabbit survival time.Results：The average concentration of blood IL-6 in 12 hours＇ hemoperfusion group was the lowest（854.2 pg·ml-1）,accompanying the longest survival time（P0.05）;Nevertheless,the average concentration of blood TNF-α in 3 hours＇ hemoperfusion group was the lowest（68.2 pg·ml-1）,P0.05,accompanying the declining of the peak,but not prolonging the survival time.Conclusion：Hemoperfusion in the early and medium-term progress of sepsis can effectively reduce the blood concentration of pro-inflammatory cytokines TNF-α and IL-6,and the later one can make the experiment rabbits＇ survival a longer time,instructing the decision of our clinical hemoperfusion timing.

关 键 词：血液灌流 脓毒症 白介素6 肿瘤坏死因子Α 

分 类 号：R631[医药卫生—外科学] R392.11[医药卫生—临床医学]