腹腔感染伴多器官功能障碍综合征时抗TNF抗体代谢调理作用的实验研究  

An experimental study of metabolic intervention of anti-TNF antibody in intra-abdominal infection complicated by multiple organ dysfunction syndrome

作　　者：全竹富[1] 刘放南[1] 陈永明[1] 臧静[1] 黎介寿[1] 

机构地区：[1]南京军区南京总医院解放军普通外科研究所,江苏南京210002

出　　处：《肠外与肠内营养》2001年第2期97-101,共5页Parenteral & Enteral Nutrition

摘　　要：目的 :观察抗TNF抗体对腹腔感染 (IAI)伴多器官功能障碍综合征 (MODS)时的代谢调理作用。　方法 :将 2 0只采用盲肠结扎加穿孔 (CLP)方法诱发的IAI伴MODS的兔随机分成两组 ,即①抗TNF血清组 :在CLP后0 .5h给予抗TNF血清 (每微升能中和TNF活性 10 0 0u) 2 .5ml/kg ;②对照组 :给予非免疫血清 2 .5ml/kg ,动态观察血清细胞因子 (TNF ,IL 6 )、激素 (皮质醇、胰岛素、胰高血糖素 )、血清生化 (葡萄糖、胆固醇、甘油三酯、白蛋白 )和每天尿中尿素氮、肌酐、3 甲基组氨酸排出的变化。两组观察时间均为 1周 ,并记录动物生存时间。　结果 :与对照组比较 ,应用抗TNF血清组血清TNF和IL 6水平下降 ,血清皮质醇升高幅度降低 ,胰岛素和胰高血糖素水平处于正常 ,血糖无显著下降 ,胆固醇和甘油三酯升高幅度减小 ,血清白蛋白水平下降减低 ,尿中尿素氮、肌酐、3 甲基组氨酸的排出量减少 ,生存率显著提高。　结论 :抗TNF抗体能够明显纠正IAI伴MODS时的代谢紊乱 ,对高分解代谢具有显著的代谢调理作用。Objectives:To observe the effect of metabolic intervention of anti TNF antibody on the hypermetabolism occurred in intra abdominal infection(IAI) complicated by multiple organ dysfunction syndrome(MODS). Methods:Twenty rabbits were operated on with cecal ligation plus puncture(CLP) inducing IAI and MODS and were randomly divided into two groups, one receiving the anti TNF serum raised against TNF α(anti TNF group) at 0.5?h after CLP and another receiving the non specific serum (control group). All animals were placed in metabolic cages and maintained with intravenous infusion for the observation period of one week. Serum levels of cytokines(TNF, IL 6), hormones (cortisol, insulin, glucagon), biochemical indexes (glucose, cholesterol, triglyceride, albumin) and daily excretions of urea nitrogen (UN),creatinine (Cr) and 3 methylhistidine (3 MH) were dynamically determined for 7 days. The death of animals was also recorded. Results:Compared with the control group, the levels of serum TNF, IL 6 and cortisol were significantly decreased and the levels of insulin and glucagon were kept normal after the injection of immune serum in anti TNF group, with significant improvements of biochemical indexes and decreased excretions of UN, Cr and 3 MH in urine. The survival rate was significantly increased in the anti TNF group. Conclusions:The anti TNF antibody can attenuate the metabolic abnormalities of IAI and MODS, being of the metabolic intervention on the hypermetabolism.

关 键 词：腹腔感染 多器官功能障碍综合征 抗TNF抗体 代谢调理 

分 类 号：R363[医药卫生—病理学]