不同时间血液灌流对脓毒症兔血IL6及TNFα水平影响.docVIP

不同时间血液灌流对脓毒症兔血IL-6及TNF-α水平的影响 　　 [摘要] 目的:通过动态检测脓毒症兔血IL-6及TNF-α水平变化,探讨行血液灌流最佳时机。方法：将18只新西兰大白兔随机分成6组,通过盲肠结扎穿孔法制作脓毒症模型,分别在术后3、6、12、24、48 h行单次血液灌流,同时设立空灌流组(对照组),并均在手术前，术后3、6、9、12、24、48 h动态检测血清中IL-6及TNF-α水平,记录各组兔子的生存时间。结果：术后12 h行血液灌流组血IL-6平均水平最低(854.2 pg#8226;ml-1),生存时间最长(73.3 h),P0.05；而术后3 h行血液灌流组血TNF-α平均最低(68.2 pg#8226;ml-1,P0.05),并使TNF-α峰值降低,但生存时间较对照组未见延长。结论：血液灌流在脓毒症早中期进行,能有效降低血前炎症细胞因子TNF-α及IL-6水平,并使实验兔生存时间延长。 　　［关键词］ 血液灌流； 脓毒症； 白介素6； 肿瘤坏死因子α 　　［中图分类号］ R631； R392.11 ［文献标识码］ A ［文章编号］ 1671-7256(2011)02-0129-05 　　doi：10.3969/j.issn.1671-7256.2011．02.003 　　Effect of hemoperfusion in different time on blood IL-6 　　and TNF-α of sepsis rabbits 　　JI Guo-ye, WANG Bin, DU Jiang, ZHANG Jian 　　(Department of Pediatrics, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China) 　　［Abstract］ Objective: To investigate the best timing to perform hemoperfusion for sepsis rabbits by detecting the dynamic concentrations of IL-6 and TNF-α. Methods: 18 rabbits were randomly divided into 6 groups. They were treated with hemoperfusion once respectively in 3 hours, 6 hours, 12 hours, 24 hours, 48 hours after the cecal ligature and puncture surgery, control group underwent fake perfusion. The blood concentration of IL-6 and TNF-α were dynamically detected before the surgery respectively, after 3 hours, 6 hours, 9 hours, 12 hours, 24 hours, 48 hours. Then we noted down the rabbit survival time. Results: The average concentration of blood IL-6 in 12 hours? hemoperfusion group was the lowest(854.2 pg#8226;ml-1), accompanying the longest survival time(P0.05); Nevertheless, the average concentration of blood TNF-α in 3 hours? hemoperfusion group was the lowest(68.2 pg#8226;ml-1), P0.05, accompanying the declining of the peak, but not prolonging the survival time. Conclusion: Hemoperfusion in the early and medium-term progress of sepsis can effectively reduce the blood concentration of pro-inflammatory cytokines TNF-α and IL-6, and the later one can make the experiment rabb