免疫吸附清除循环肿瘤坏死因子-α对内毒素休克时血液循环的影响  

Effects of removing of circulatory tumor necrosis factor-α by immunoabsorption on blood circulation during endotoxic shock

作　　者：梁敏[1] 张训[1] 侯凡凡[1] 

机构地区：[1]第一军医大学附属南方医院肾内科,广州510515

出　　处：《中华创伤杂志》2000年第9期547-549,共3页Chinese Journal of Trauma

基　　金：国家自然科学基金!资助项目 (39370 336 )

摘　　要：目的　观察应用免疫吸附清除循环肿瘤坏死因子 -α(TNF -α)对内毒素休克兔血液循环的影响。　方法　给新西兰白兔一次性静注大肠杆菌内毒素建立内毒素休克动物模型 ,然后将兔随机分为 3组 :(1)对照组 :未行血液灌流 ;(2 )空灌流组 :用空灌流器进行血液灌流 ;(3)免疫吸附组 :用结合抗TNF -α单克隆抗体的免疫吸附灌流器进行血液灌流。对 3组兔进行相应处理后观测其血浆TNF -α活性、血压和微循环变化。　结果　 (1)静脉注射内毒素后血浆TNF -α活性迅速升高 ,免疫吸附组 2 ,3 ,6h血浆TNF -α活性明显低于其他两组 (P <0 .0 5 ) ;(2 )注射内毒素导致血压持续性下降 ,免疫吸附治疗后逐渐回升 ;(3)免疫吸附治疗后微循环障碍明显缓解。　结论　免疫吸附清除循环TNF -α可能是一种治疗内毒素休克的有效手段。Objective To evaluate the protective effect of removing circulating tumor necrosis factor-α(TNF-α) on blood circulation by immuno-absorption in endotoxic shock. Methods Twenty-four New Zealand white rabbits were injected intravenously with lethal dose of Lipopolysaccharide( LPS, Escherichia coli O111:B4 8.0×10 9 cfu/kg), and randomly divided into 3 groups: perfusion group, hemoperfusion started at 1 h after LPS administration through immunoabsorbent columns against TNF-α; pseudoperfusion group, hemoperfusion through blank columns; and control group, injected with LPS only. The plasma TNF-α activity, mean aortic pressure, as well as microcirculation of mesentery including the diameters of the third-order arteria (A 3) and venous (V 3), erythrocyte velocity and blood flow rate were detected. Results Plasma levels of TNF-α were sharply reduced after immunoabsorption. Moreover, decreased MAP and abnormal microcirculation were improved significantly. Conclusions Specific removal of circulating TNF-α byimmunoabsorption might be a new and effective therapy for endotoxic shock.

关 键 词：内毒素休克 免疫吸附 肿瘤坏死因子Α 血液循环 

分 类 号：R392[医药卫生—免疫学]