摘要
目的 观察火器伤烟雾吸入致重度吸入性肺损伤后支气管肺泡灌洗液(BALF)中致炎、抗炎细 胞因子含量变化,及其在多器官功能损害中的作用。方法 复制火器伤致大鼠重度吸入性肺损伤模型。观察 大鼠伤后2、4、6、8、12和24 h肺湿重／于重比,BALF中自蛋白、乳酸脱氢酶(LDH)、肿瘤坏死因子-α (TNF-α)、白细胞介素-6(IL-6)、IL-4的含量,外周血丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、血尿 素氮(BUN)、血肌酐(SCr)、肌酸激酶同工酶(CK-MB)含量,并与正常对照组比较。结果 大鼠肺湿重／干重 比、BALF中白蛋白及LDH含量随时间的延长而增加;TNF-α在损伤后即增加,2 h达高峰;IL-6损伤后 4 h明显增加,且伤后4-24 h保持较高浓度;IL-4于伤后6-8 h下降。外周血ALT、AST、BUN、SCr、 CK-MB伤后持续增加。结论 细胞因子可能是介导多器官功能损害的直接介质。多器官功能损害可能由 TNF-α触发,随后引起细胞因子的级联反应,致炎因子IL-6的持续高表达和抑炎因子IL-4后期失控加剧 了MOF的发展。
Objective To observe the phasic variations in concentrations of pro-inflammatory and anti-inflammatory cytokines, and to explore their potential roles in the occurrence and development process of multiple organ dysfunction. Methods Fire-arm induced aspiration lung injury model was replicated. The following parameters were observed： wet/dry weight ratio of rat＇s lungs, contents of albumin and lactate dehydrogenase （LDH）, concentrations of tumor necrosis factor-α （TNF-α）, interleukin-6 （IL-6） and IL-4 in bronchoal alveolar lavage fluid （BALF）, contents of alanine amino transferase （ALT）, asparate aminotransferase （AST）, blood urea nitrogen （BUN）, serum creatinine （SCr）, and MB isoenzyme of creatine kinase （CK-MB）. Results The wet/dry weight ratio of rat＇s lungs and contents of albumin and LDH in BALF increased with the passage of time. The concentration of TNF-α increased immediately after injury and reached the peak value at 2 hours. The concentration of IL-6 increased obviously 4 hours after injury, and maintained a high level from 4 hours to 24 hours. The concentration of IL-4 decreased from 6 hours to 8 hours after injury. The contents of ALT, AST, BUN, SCr and CK-MB increased continually after injury. Conclusion Cytokines are the direct mediators for multiple organ failure （MOF）, and MOF is triggered by TNF-α and a cascade of cytokine release, with a prolonged high -expression of IL-6. The loss of control of IL-4 aggravates the development of MOF.
出处
《中国危重病急救医学》
CAS
CSCD
北大核心
2005年第12期732-735,T0002,共5页
Chinese Critical Care Medicine
基金
总后卫生科研基金资助项目(04M009)全军医学科研"十五"计划
