脓毒症及严重脓毒症患者外周血转化生长因子-β1的表达变化及其在炎症反应中的作用  

Serum TGF -β1 in patients with sepsis and severe sepsis and the effect on inflammatory

作　　者：李锐[1] 邢静[1] 王为[1] 张彧[1] 

机构地区：[1]大连医科大学附属第一医院急诊科,辽宁大连116011

出　　处：《中国急救医学》2016年第3期215-218,共4页Chinese Journal of Critical Care Medicine

基　　金：基金项目：辽宁省教育厅科学研究一般项目（L2014353）

摘　　要：目的动态观察脓毒症、严重脓毒症患者外周血转化生长因子-β1（TGF-β1）的表达变化，了解TGF-β1在不同严重程度的脓毒症患者中的表达变化特点及差异，同时通过复制大鼠脓毒症模型，探讨不同浓度的TGF-β1对促炎因子TNF—α的影响。方法32例患者人选，其中脓毒症者14例，严重脓毒症者18例，在人院当日、入院后第3天及第7天检测患者外周血中TGF-β1表达水平。动物实验：通过盲肠结扎穿孔法（cecal ligation puncture，CLP）制备大鼠脓毒症模型，经尾静脉注射不同浓度的TGF-β1，ELISA法检测各组大鼠血清中TNF-α表达变化，探讨不同浓度TGF-β1调节炎症反应的作用。结果在入院后第7天严重脓毒症患者外周血TGF-β1表达水平[891．37（293．59—1227．44）]较脓毒症患者[192．64（0～302．49）]明显升高，差异有统计学意义（P〈0．05）。在脓毒症大鼠模型中，不同浓度的TGF-β1对促炎因子TNF-α影响不同，当TGF-β1浓度为5ng／（mL·250g）时，TNF—α表达水平（77．56±7．2）明显升高（P〈0．05）；当给药浓度增加为50ng／（mL·250g）时，TNF—α表达水平（69．71±8．29）也升高，但较给予TGF-β15ng／（mL·250g）浓度时TNF—α的生成减少。结论TGF-β1在脓毒症炎症反应中发挥重要作用，与疾病的严重程度相关；不同浓度的TGF—Bl在体内可能发挥不同的调节作用，影响炎症的结局。Objective This study aimed to investigate the dynamic change of TGF - β1 in serum of patients with sepsis and severe sepsis, meanwhile, to investigate serum TNF -α concentration in CLP rat model after the treatment of TGF - β1 injection in order to evaluate the effect of TGF - β1 on inflammatory. Methods Clinical investigation： according to the diagnostic criteria for sepsis and severe sepsis, we collected sepsis and severe sepsis cases who were in Emergency Intensive Care Unit from December 2013 to December 2014 in the First Affiliated Hospital of Dalian Medical University. Cases must be confirmed and serum samples must be collected on the day and 3th, 7th day in hospital. Serum TGF- β1 concentration was detected. Animal experiment： a total of 40 Sprague- Dawley rats were used. The rats were randomly divided into four groups, including group control （n = 10）, group model （n=10）, group treatment of TGF-β1 with 5 ng/（mL · 250 g） （n = 10） and group treatment of TGF -β1 with 50 ng/（mL · 250 g） （n = 10）. Rats in groups control were sacrificed after anesthesia. Rats in groups model and group treatment were injected fluid 0.5 h after CLP. The injection fluid for groups model was NS, the injection fluid for group treatment is TGF - β1 with different concentration [ 5ng/（mL · 250 g） and 50 ng/（mL ·250 g） ]. All the rats were sacrificed at 6 b after CLP. The serum was collected to investigate the level of TNF - α at the same time. Results Compared with sepsis group, serum TGF - β1 concentration of severe sepsis group was significantly higher at 7th day in hospital （P 〈 0.05 ）. In CLP rat model, level of TNF -α was different between group treatment of TGF - β1 with 5 ng/（ mL · 250 g） and group treatment of TGF - β1 with 50 ng/（ mL · 250 g）. Serum TNF -α concentration either increased after 5 ng/（ mL · 250 g） TGF - β1 injection or 50 ng/（ mL · 250 g） TGF - β1 injection. However, compared with group treatment of TGF - β1 with 5 ng/（ mL · 25

关 键 词：脓毒症 严重脓毒症 转化生长因子-β1(TGF-β1) 炎症反应 

分 类 号：R575.2[医药卫生—消化系统]