头孢曲松有潜在加剧脓毒症免疫抑制的风险  

Ceftriaxone may potentially exacerbate the immunosuppressive risk in sepsis

作　　者：章德文[1] 何建[1] 

机构地区：[1]第二军医大学附属长海医院,上海200433

出　　处：《内科急危重症杂志》2012年第4期212-213,共2页Journal of Critical Care In Internal Medicine

摘　　要：目的:研究头孢曲松对脓毒症模型小鼠脾脏树突状细胞(DCs)的影响,及其临床意义。方法:96只雄性昆明鼠随机分配入组,正常对照组(A组)40只、脓毒症模型组(B组)32只、头孢曲松治疗组(C组)24只。采用盲肠结扎穿孔术(CLP)制模,制模后0、12、24、48、72h分批处死小鼠,流式细胞计数脾脏DCs及凋亡率。结果:与正常观察组比较,模型组所有观察时间点脾脏DCs数量明显减少,凋亡率增加(均P﹤0.05);给予头孢曲松治疗后脾脏DCs的丢失进一步加剧(P﹤0.05),但凋亡率无显著改变(P﹥0.05)。结论:严重脓毒症时脾脏DCs明显减少。常规使用头孢曲松加剧DCs的丢失,但凋亡率无显著改变,推测源于单核细胞向DCs的分化障碍,从而加剧了免疫抑制和炎症失衡。Objective： To study the effect of Ceftriaxone on splenic dendritic cells （DCs） in rat model of sepsis and its clinical significance. Methods ： Ninety-six male Kunming rats were randomly divided into group A （ control group, n = 40） , group B （sepsis model group, n =32） , group C （Ceftriaxone group, n =24）. The rats were sacrificed at 0, 12, 24, 48 and 72 hours after cecal ligation and puncture （CLP） , and the amount and apoptosis of splenic DCs were counted by flow cytometry. Results： The number of DCs decreased and the apoptotic rate increased significantly in CLP group at all time points compared with those of control group （ P 〈 0.05 ）. After administration of Ceftriaxone, the loss of splenic DCs con- tinued to aggravated （ P 〈 0.05 ）, but the apoptotic rate remained unchanged significantly （ P 〉 0.05 ）. Conclusions ： The number of splenic DCs decreased markedly during the course of severe sepsis. The routine use of Ceftriaxone further de- creased the number of DCs but without further increasing the apoptosis of DCs, which is presumably due to altered differen- tiation of moncytes to DCs, thus aggravating immunosupprssion and inflammatory imbalance.

关 键 词：脓毒症 DCS 凋亡 头孢菌素 免疫抑制 

分 类 号：R515.3[医药卫生—内科学]