免疫吸附清除循环肿瘤坏死因子对内毒素休克兔肝脏改变的影响  

The effects of removing circulated tumor necrosis factor by immunoadsorption on hepatic changes of rabbits with endotoxin shock

作　　者：林跃萍[1] 张训[1] 侯凡凡[1] 

机构地区：[1]第一军医大学附属南方医院肾内科,广州510515

出　　处：《第一军医大学学报》1999年第6期500-503,共4页Journal of First Military Medical University

基　　金：国家自然科学基金!(39370 336)

摘　　要：目的　应用抗肿瘤坏死因子 (TNF)单克隆抗体 (McAb)免疫吸附方法清除循环TNF ,观察其对内毒素休克兔肝脏改变的影响。方法以致死剂量内毒素 (8× 10 9CFU/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 )。注射内毒素 1h后开始体外循环免疫吸附 ,监测平均动脉压 (MAP) ,观察两组循环血TNF及丙氨酸转氨酶 (ALT)、天门冬氨酸转氨酶 (AST)水平。于 6h后活杀动物 ,留取肝脏行组织病理检查。结果 (1)免疫吸附组 90min后MAP开始回升 [(11 6±1 4)kPa],此后一直明显高于 [(9 2± 2 0 )kPa]对照组 (P <0 0 5 ) ;(2 )免疫吸附组 2h的TNF活性 [(43 6± 10 4)× 10 3 U/L]较对照组 [(144 8 6± 2 2 6 9)× 10 3 U/L]明显降低 (P <0 0 5 )。 (3)免疫吸附组血清ALT、AST水平较对照组降低 (P <0 0 5 )。 (4)免疫吸附组肝脏病理损害程度较对照组明显减轻。结论抗TNFMcAb特异性免疫吸附方法 ,能有效清除循环TNF ,减轻肝脏的病理损害程度。Objective To remove circulating tumor necrosis factor (TNF) by specific immunoadsorption column contaning anti-TNF monoclonal antibody (McAb) and observe the effects of this method on hepatic changes in experimental rabbits with endotoxin shock Methods New Zealand white rabbits in both control group (n=7) and perfusion group (n=10) were injected with lethal dose of E coli endotoxin ( 8×10 9 CFU/kg ) to produce endotoxin shock, and the perfusion started at the end of first hour after the administration of endotoxin Blood samples were collected for assay of TNF, alanine transaminase (ALT) and aspartic transaminase (AST) 6 h after injection of endotoxin, rabbits were sacrificed and the liver was taken for pathologic observation Results (1) MAP increased 30 min after perfusion in perfusion group, keeping at a higher level than that in control group throughout the monitoring period (P<0 05) (2) The plasma TNF activation was reduced significantly in perfusion group ((43 6±10 4) ×10 3 U/L) compared with control group( (1 448 6±226 9)×10 3 U/L, P<0 05)1 h after perfusion (3)The levels of ALT and AST decreased in perfusion group (4)The degree of hepatic damages in the control group was more severe than that in the perfusion group Conclusion Specific immunoadsorption column containing anti-TNF McAb can effectively remove circulating TNF in blood when endotoxin shock occurs and reduce the pathologic damages of the liver

关 键 词：内毒素休克 肿瘤坏死因子 免疫吸附 肝脏 

分 类 号：R515.306[医药卫生—内科学] R757.05[医药卫生—临床医学]