聚偏氟乙烯-丝氨酸新型吸附膜血液灌流对猪内毒素血症肠损伤的影响  

Effect of hemoperfusion with absorbents using polyvinylidene difluoride-serine on intestinal injuries in porcine model with endotoxemia

作　　者：郑永科[1,2] 徐秋萍[1] 

机构地区：[1]浙江大学附属邵逸夫医院危重病医学科,杭州在职研究生310016 [2]杭州市第一人民医院危重病医学科

出　　处：《中华危重症医学杂志（电子版）》2012年第6期10-14,共5页Chinese Journal of Critical Care Medicine:Electronic Edition

基　　金：浙江省科技攻关计划重点项目(2007C33008)

摘　　要：目的研究应用聚偏氟乙烯(PVDF)-丝氨酸(Ser)新型吸附膜进行血液灌流治疗对猪内毒素血症肠损伤的影响及探讨可能存在的机制。方法将内毒素以1μg·kg-1·h-1静脉泵入猪体内2h构建内毒素血症模型。13只猪分为两组,实验组(7只),内毒素血症模型制作完成后开始应用PVDF-Ser吸附膜进行血液灌流持续2h;对照组(6只),采用空载体血液灌流对照试验。监测实验动物的血浆内毒素、肿瘤坏死因子α(TNF-α)和白细胞介素6(IL-6)水平;实验结束后处死动物,取其肠组织以检测干湿重比、TNF-α和IL-6水平、丙二醛(MDA)、谷光苷肽(GSH)及髓过氧化物酶(MPO)活性,并对肠组织进行病理学观察和MPO免疫组化分析。结果在实验完成时,实验组动物的血浆内毒素水平及血清IL-6水平较对照组明显降低(P均<0.05)。两组间肠组织的TNF-α、IL-6、MDA、GSH水平及MPO活性的比较均有统计学意义(P均<0.05),且实验组肠组织的干湿重比及MPO阳性细胞数明显低于对照组(P均<0.05)。结论应用PVDF-Ser吸附膜进行血液灌流治疗猪内毒素血症,可以降低氧化应激和炎症反应,改善肠损伤。Objective To study the effect of hemoperfusion with a new type absorbent containing polyvinylidene difluoride （PVDF）-serine （Ser） on intestinal injury in porcine model with endotoxemia. Methods Thirteen pigs were injected endotoxemia （1 μg·kg-1·h-1 intravenously） for 2 h and randomly divided into two groups： pigs treated with absorber of PVDF-Ser volume （experiment group, 7 pigs） or empty absorber （control group, 6 pigs） for 2 h, and sacrificed after hemoperfusion. Blood samples were drawn and endotoxin, tumor necrosis factor α （TNF-α） and interleukin 6 （IL-6） were measured during the experiment. The ratio of dry/wet, levels of TNF- α, IL-6, malondialdehyde （MDA）, glutathione （GSH）, myeloperoxidase （MPO） activity, histological changes in the intestinal tissues and MPO immunohistochemical analysis were detected and assessed. Results After hemoperfusion, the levels of serum endotoxin and IL-6 in the exper/ment group were much lower than those in the control group （all P 〈 0.05）. The levels of TNF-α, IL- 6, MDA, GSH and MPO activity in the intestinal tissues all showed significant differences between the two groups. The ratio of dry/wet and the number of MPO positive cells in the experiment group decreased markedly as compared to the control group. Conclusion Hemoperfusion with the absorber of PVDF-Ser volume can effectively decrease inflammatory responses and edema, improve intestinal injuries and oxidative stress in endotoxemia.

关 键 词：聚偏氟乙烯 丝氨酸 血液灌流 内毒素血症 

分 类 号：R459.5[医药卫生—治疗学]