摘要
目的:研究连续性肾脏替代治疗(CRRT)过程中多器官功能障碍综合征(MODS)患者血清对体外培养血管内皮细胞分泌组织因子(TF)及纤溶酶原激活物抑制剂-1(PAI-1)的影响。方法:16例MODS患者随机分为两组,一组给予无肝素CRRT治疗,另一组给予普通肝素抗凝的CRRT治疗。观察患者行CRRT治疗8h过程中的变化,在治疗0min、15min、1h、2h、8h时分别留取血样5mL。ELISA法检测患者血清TNF-α、IL-1β水平。观察CRRT治疗不同时间点血清对内皮细胞分泌TF及PAI-1蛋白水平的影响,RT-PCR法检测TF及PAI-1mRNA水平的表达。结果:MODS患者血清可明显增加体外培养血管内皮细胞TF及PAI-1的分泌,经CRRT治疗后,患者血清对内皮细胞分泌TF及PAI-1的影响逐步减小。无肝素组内皮细胞分泌TF及PAI-1蛋白水平与相应干预血清TNFα水平均呈正相关,相关系数分别为0.902,0.939(P<0.05);肝素组内皮细胞分泌TF及PAI-1水平与相应干预血清TNFα水平均无相关性(P>0.05)。结论:MODS患者血清促进内皮细胞分泌TF及PAI-1,内皮细胞功能明显异常,可能与炎症介质有关。CRRT治疗可清除血液中激活/损伤内皮细胞的成分,改善患者内皮细胞功能。
AIM：To elucidate the effects of serum of patients with multiple organ dysfunction syndrome （MODS） on tissue factor （TF） and Plasminogen activator inhibitor-1 （PAI-1） secretion of human vascular endothelial cells（HUVEC）during continuous renal replacement therapy （CRRT）. METHODS：Sixteen patients who diagnosed MODS involved were divided into two groups randomly,eight patients treated with CRRT without heparin and the others with heparin for 8 hours. The blood was collected from patients at 0 min,15 min,60 min,120 min and 480 min during CRRT.Serum TNF-α,IL-1β were measured by ELISA.TF and PAI-1 secretion of HUVEC stimulated with serum of patients with MODS undergoing CRRT were detected. TF and PAI-1 expression level were assayed by RT-PCR. RESULTS：TF and PAI-1 secretion were significantly increased in HUVEC stimulated with serum of patients with MODS,but the levels were decreased after CRRT.There are significant positive correlation between TF or PAI-1 secretion of HUVEC and corresponding serum TNFαlevel in the group without heparin,the coefficient correlation is 0.902 and 0.939（P〈0.05）respectively.But there are not significant correlation（P〉0.05）in the group with heparin. CONCLUSION：Serum of patients with MODS promote the secretion of TF and PAI-1 in HUVEC.The dysfunction of HUVEC induced by serum of patients with MODS may be related to mediators of inflammation.CRRT can clean up the component which injure HEVEC and improve endothelial cell functions.
出处
《细胞与分子免疫学杂志》
CAS
CSCD
北大核心
2009年第6期534-536,539,共4页
Chinese Journal of Cellular and Molecular Immunology
