摘要
目的探讨休克后促炎细胞因子表达释放的时相性变化。方法80只SD大鼠被随机分为失血性休克组（40只）和对照组（40只）。于休克后30、60和90min及复苏后30min和90min各处死8只大鼠，采用逆转录-聚合酶链反应（RT～PCR）检测失血性休克后各时间点肠、肝、肺组织内肿瘤坏死因子-α（TNF—α）、白细胞介素-1β（IL-1β）、IL-6的mRNA表达，采用酶联免疫吸附试验（ELISA）双抗体夹心法测定血清中TNF—α、IL-6的含量。结果①休克30min时，肠、肝、肺组织中促炎细胞因子的mRNA表达均未见升高；休克60min肠道首先出现TNF—α mRNA表达升高（P〈0．05），而肝脏在休克90min时表达开始升高（P〈0．01），肺脏则在复苏后30min表达开始升高（P〈0．05）。复苏后90min肠、肝、肺组织中TNF—α mRNA表达仍高于对照组（P均〈0．01）。TNF—α mRNA在肠、肝、肺内的表达升高最早，其后才是IL-1β mRNA和IL-6 mRNA。②休克30min门静脉血和下腔静脉血中TNF—α、IL-6的含量与对照组比较差异均无显著性，而休克60min时门静脉血中TNF—α含量显著升高（P〈0．05）；休克90min、复苏后30min和90min门静脉血和下腔静脉血中TNF—α、IL-6含量均较对照组显著升高（P均〈0．01）。结论失血性休克时细胞因子的释放顺序县肠道、肝脏和肺脏。椎测存在“肠→肝→肺”细胞因子释放轴。
Objective To study the kinetics of expression and release of major pro -inflammatory cytokines in the vital organs after hemorrhagic shock. Methods Eighty Sprague - Dawley （SD） rats were randomly divided into hemorrhagic shock group （n = 40） and control group （n = 40）. Eight rats were sacrificed at 30, 60 and 90 minutes respectively after shock and 30 and 90 minutes respectively after resuscitation. The expressions of mRNA of tumor necrosis factor - α （TNF - α）, interleukin - 16 （IL - 1β）, and IL -6 in intestine, liver, lung tissues were assessed by reverse transcription- polymerase chain reaction （RT - PCR）, and the release of TNF - α and IL - 6 in blood serum were determined by enzyme - linked immunosorbent assay （ELISA）. Results （1） The pro -inflammatory cytokines were not increased in intestine, liver and lung tissues at 30 minutes after shock. The TNF-α mRNA expression was first up - regulated in the intestine at 60 minutes after shock （P〈0. 05）, followed by the liver at 90 minutes after shock （P〈0.01） and then the lung at 30 minutes after resuscitation （P〈0.05）. The TNF-α mRNA expressions in intestine, liver and lung tissues were higher at 90 minutes after resuscitation compared with those of control group （all P^0. 01）. The expressions of mRNA of TNF - α, IL - 16, IL - 6 in the vital organs could be successively increased after hemorrhagic shock and resuscitation, with the TNF -α mRNA / expression being the earliest, followed by the IL - 16 mRNA and IL - 6 mRNA. （2）The levels of TNF - α were increased in portal bloodstream prior to peripheral blood, and TNF - α preceded IL - 6 at 60 minutes after shock （P〈0.05）, while there were no significant differences in the levels of TNF - α and IL - 6 in portal bloodstream and peripheral blood at 30 minutes after shock, but they were higher than those of control group at 90 minutes after shock and at 30 and 90 minutes after resuscitation （all P〈0. 01）. Conclusion There is gut - liver - lung axis in the kinetics of expression and release of major pro - inflammatory cytokines after hemorrhagic shock.
出处
《中国危重病急救医学》
CAS
CSCD
北大核心
2007年第5期290-294,共5页
Chinese Critical Care Medicine
基金
上海市卫生局科技发展基金资助项目（034074）
