免疫吸附清除循环肿瘤坏死因子-α对内毒素休克兔肠道改变的影响  

Effect of removing circulating tumor necrosis factorα by immuoadsorption on intestinal changes in rabbits with endotoxic shock

作　　者：林跃萍[1] 张训[1] 侯凡凡[1] 

机构地区：[1]第一军医大学南方医院肾内科

出　　处：《中国危重病急救医学》1999年第8期469-471,共3页Chinese Critical Care Medicine

基　　金：国家自然科学基金

摘　　要：目的：用抗肿瘤坏死因子α（ＴＮＦα）单克隆抗体（ＭｃＡｂ）免疫吸附法特异性清除循环ＴＮＦα，观察其对内毒素休克兔肠道改变的影响。方法：以致死剂量内毒素（８×１０９ＣＦＵ／ｋｇ）制成内毒素休克兔模型后分为对照组（ｎ＝７）及免疫吸附组（ｎ＝１０）。６０分钟后开始体外循环免疫吸附，监测平均动脉压（ＭＡＰ），观察２组循环ＴＮＦα水平。３６０分钟活杀动物，取小肠行组织病理检查。结果：①免疫吸附组血液灌流后９０分钟ＭＡＰ开始回升〔（１１．６±１．４）ｋＰａ，１ｋＰａ＝７．５ｍｍＨｇ〕，此后一直高于对照组（Ｐ均＜０．０５）。②免疫吸附组１２０分钟以后ＴＮＦα活性均较对照组明显降低（Ｐ均＜０．０５）。③免疫吸附组肠粘膜损害程度较对照组明显减轻。结论：抗ＴＮＦαＭｃＡｂ特异性免疫吸附方法能有效清除循环ＴＮＦα，减轻肠道的病理损害。Objective:To remove circulating tumor necrosis factorα(TNFα) by specific immunoadsorption column containing antiTNFα monoclonal antibody (McAb) and observe the effect of immunoadsorption on intestinal changes in endotoxic shock.Methods:New Zealand white rabbits were injected with lethal dose of E.coli endotoxin (8×10 9 CFU/kg) to produce endotoxic shock,then they were divided into control group ( n =7) and perfusion group ( n =10).Perfusion was started at 1 hour after beginning of endotoxin administration.Blood samples were collected for assay of TNFα.At 6 hours after infusion of endotoxin,rabbits were sacrificed then the small intestine was taken for pathologic examination.Results:MAP increased at 90 minutes after the beginning of perfusion in perfusion group (11 6±1 4)kPa,1 kPa=7 5 mmHg ,it kept at a higher level than that in control group during monitoring period (12 4±1 2)kPa,all P <0 05 .The plasma TNFα activity was reduced significantly in perfusion group compared with control group (all P <0 05)after 2 hours of perfusion.The degree of pathologic damage in small intestine in perfusion group was reduced markedly in comparison with controls.Conclusions:Specific immunoadsorption column containing antiTNFα McAb can effectively remove circulating TNFα in experimental endotoxin shock.Inhibition of TNFα levels at the early phase of endotoxic shock would expect to ameliorate the state of hypotension.It may be a new method in the treatment of multipleorgan damage associated with endotoxic shock.

关 键 词：内毒素休克 肿瘤坏死因子 免疫吸附 肠道 

分 类 号：R631.402[医药卫生—外科学] R364.7[医药卫生—临床医学]