高容量血液滤过治疗对猪脓毒症模型炎症介质的影响  

Effect of high volume hemofiltration therapy on inflammatory mediators in swine sepsis model

作　　者：涂杳然 TU Yao-ran(Emergency Center,the Third Affiliated Hospital of Nanchang University,Jiangxi Province,Nanchang330008,China)

机构地区：[1]南昌大学第三附属医院急创中心

出　　处：《中国当代医药》2020年第4期32-35,共4页China Modern Medicine

基　　金：江西省卫生计生委科技计划项目(20177018)

摘　　要：目的探讨研究高容量血液滤过治疗对猪脓毒症模型炎症介质的影响。方法将15只约克夏健康家猪通过静脉注射内毒素诱导复制猪脓毒症模型,并将其随机分为对照组、CVVH治疗组、HVHF治疗组三组,每组5只。对照组动物不进行血液滤过治疗,CVVH组行常规剂量血液滤过治疗,HVHF组行高容量血液滤过治疗。比较三组动物在内毒素注射前(T0)、模型建立时(T1)及治疗2(T2)、治疗4(T3)、治疗6(T4)h不同时间的动物体温(T)、心率(HR)、平均动脉压(MAP)的变化,并对比三组动物在治疗不同时间的白细胞介素-6(IL-6)、白细胞介素-10(IL-10)以及肿瘤坏死因子-α(TNF-α)等炎症介质的变化情况。结果CVVH组和HVHF组T3、T4的T低于对照组,HR慢于对照组,MAP则高于对照组(P<0.05),且HVHF组的T3、T4时段的T低于CVVH组,HR慢于CVVH组,MAP高于CVVH组(P<0.05)。CVVH组和HVHF组动物的T2、T3及T4的IL-6、IL-10、TNF-α均低于对照组(P<0.05),且HVHF动物的T3、T4的IL-6、IL-10、TNF-α均低于CVVH组(P<0.05)。结论高容量血液滤过治疗能更有效地清除猪脓毒症模型体内过度释放的炎症介质,减轻炎症反应,并改善血液动力学指标。Objective To study the effect of high volume hemofiltration on the inflammatory mediators in swine sepsis model.Methods A total of 15 Yorkshire healthy pigs were induced to replicate the swine sepsis model by intravenous Endotoxin.The models were randomly divided into three groups:control group,CVVH treatment group and HVHF treatment group,with 5 pigs in each group.The animals in the control group were not treated with hemofiltration,the CVVH group was treated with routine dose hemofiltration,and the HVHF group was treated with high volume hemofiltration.The changes of body temperature(T),heart rate(HR)and mean arterial pressure(MAP)in three groups of animals at different time of before endotoxin injection(T0),at the time of establishment of the model(T1)and at 2(T2),4(T3)and 6(T4)h were compared.The changes of interleukin-6(IL-6),interleukin-10(IL-10)and tumor necrosis factor-α(TNF-α)in the three groups at different time were compared.Results The T at T3 and T4 in CVVH group and HVHF group were lower than those in control group,and the HR was slower than that in control group,while MAP was higher than that in control group(P<0.05).The T at T3 and T4 in HVHF group were lower and HR was slower than that in the CVVH group,and MAP was higher than that in the CVVH group(P<0.05).The levels of IL-6,IL-10,and TNF-αat T2,T3 and T4 in CVVH group and HVHF group were lower than those in control group(P<0.05),and the IL-6,IL-10 and TNF-αat T3 and T4 in HVHF group were lower than those in CVVH group(P<0.05).Conclusion High volume hemofiltration can effectively eliminate the excessive released inflammatory agents in the swine sepsis model,reduce the inflammatory response and improve the hemodynamic index.

关 键 词：高容量血液滤过 脓毒症 模型 炎症介质 

分 类 号：R459.7[医药卫生—急诊医学]