摘要
目的 观察丙泊酚对烧冲复合伤犬外周血单个核细胞（PBMC）及细胞间黏附分子（ICAM-1）的影响.方法 将32只雄性比格犬按随机数字表法分为：正常对照组、复合伤对照组、丙泊酚1组、丙泊酚2组各8只,除正常对照组外其余3组均致重度烧冲复合伤,4组犬均按Parkland公式补充乳酸钠林格注射液,丙泊酚1组、丙泊酚2组在补液同时分别连续输注2、5 mg·kg^-1·h^-1丙泊酚注射液,持续72 h.4组犬在伤前及伤后6、24、48、72 h分别采取外周静脉血,酶联免疫吸附（ELISA）法检测各组ICAM-1和淋巴细胞功能相关抗原1（LFA-1）水平;流式细胞仪检测各组CD14^＋单核细胞犬主要组织相容性复合体（MHC）抗原表达率;CD4^＋/CD8^＋T淋巴细胞比值和PBMC凋亡率.结果 复合伤对照组伤后24、48、72 h的ICAM-1水平分别为（10.5±1.1）、（10.8±1.3）、（12.3±1.4） ng/ml,均显著高于正常对照组的（7.4±1.4）、（7.4±1.1）、（7.4±1.6）ng/ml（均P＜0.05）;丙泊酚1组、丙泊酚2组伤后72 h的ICAM-1水平分别为（10.7±1.3）、（8.8±1.4） ng/ml,均显著低于复合伤对照组（均P＜0.05）,且丙泊酚2组显著低于与丙泊酚1组（P＜0.05）.复合伤对照组伤后24、48、72 h的LFA-1水平分别为（7.3±1.3）、（8.4±1.3）、（9.6±1.7） ng/ml,均显著高于正常对照组的（5.1±1.2）、（5.4±1.3）、（5.8±1.2） ng/ml（均P＜0.05）.丙泊酚2组伤后72 h的MHC表达率均显著高于复合伤对照组和丙泊酚1组[（46±13）％比（26±15）％和（32±12）％]（均P＜0.05）.丙泊酚1组和丙泊酚2组伤后48、72 h的CD4 ＋/CD8^＋T淋巴细胞比值分别为（1.71±0.26）、（1.82±0.31）和（1.81±0.24）、（1.96±0.24）,均显著高于复合伤对照组的（1.41±0.34）、（1.34±0.26） （P ＜0.05）.伤后72 h复合伤对照组、丙泊酚1组凋亡率分别为（2.57±0.21）％、（1.64±0.10）％,均显著高于正常对照组的（0.81±0.11）％（均P＜0.01）;丙泊酚2组的凋亡率（1.09±0.15）％显著低于复合伤对照组和丙泊酚1组（均P＜0.01）.结论 丙泊酚可能通过剂量依赖性的方式抑制ICAM-1过度释放和PBMC凋亡,从而改善烧冲复合伤后免疫功能.
Objective To observe the effects of continuous sedation with propofol on peripheral blood mononuclear cell （PBMC） and intercellular adhesion molecule 1 （ICAM-1） in beagles with combined bum-blast injuries.Methods A total of 32 male beagles were randomly divided into 4 groups of normal control （NC）,combined injury control （CC）,propofol 1 （P1） and propofol 2 （P2） （n =8 each）.Except for NC group,the other 3 groups were subject to severe combined bum-blast injury.And sodium lactate Ringer＇s solution was infused after trauma according to the Parkland formula,including NC group.At the same time,P1 and P2 groups received continuous intravenous infusions of 2 mg · kg^-1 · h^-1,5 mg · kg^-1 · h^-1doses of propofol respectively for 72 hours.The serum concentrations of ICAM-1 and lymphocyte function associated antigen-1 （LFA-1） were measured by enzyme-linked immunosorbent assay （ELISA） at 6,24,48,72 h post-injury.Flow cytometry was used to detect the major histocompatibility complex （MHC） antigen expression on CD14^＋ monocytes,CD4^＋/CD8^＋ T lymphocyte rate and PBMC apoptosis rate.Results The level of ICAM-1 in CC group （（10.5 ± 1.1）,（10.8 ± 1.3）,（12.3 ± 1.4） ng/ml） was significantly higher than that in NC group （（7.4±1.4）,（7.4±1.1）,（7.4±1.6） ng/ml） at 12,24,48 h postinjury （all P 〈 0.05）.The level of ICAM-1 in P1 group was significantly lower than that in CC group （（10.7 ± 1.3） vs （12.3 ± 1.4） ng/ml） while the level of ICAM-1 in P2 group was significantly lower than that in P1 group at 72 h post-injury （（8.8 ± 1.4） vs （10.7 ± 1.3） ng/ml） （both P 〈0.05）.The level of LFA-1 in CC group （（7.3 ± 1.3）,（8.4 ± 1.3）,（9.6 ± 1.7） ng/ml） was significantly higher than that in NC group （（5.1 ± 1.2）,（5.4 ± 1.3）,（5.8 ± 1.2） ng/ml） at 24,48,72 h post-injury （all P 〈 0.05）.MHC antigen expression on the CD14^＋ monocytes of P2 group was obviously higher than that of CC and P1 groups （（46 ± 13） % vs （26 ± 15） % and （32 ± 12） %,both P 〈 0.05）.The CD4/CD8 rate in P1 and P2 was significantly higher than that in CC group （1.71 ±0.26,1.82 ±0.31 and 1.81 ±0.24,1.96 ±0.24 vs 1.41 ±0.34,1.34 ±0.26） at 48,72 h post-injury （all P 〈0.05）.At 72 h post injury,the PBMC apoptosis rate in CC and P1 group was obviously higher than that of the NC group （（2.57 ± 0.21） % and （1.64 ± 0.10）% vs （0.81 ± 0.11）%） （both P 〈 0.01） ; the apoptosis rate in P2 group was significantly lower thanthat in P1 group （（1.09±0.15）% vs （1.64±0.10）%） （P〈0.01）.Conclusion Propofol may improve the immune function after combined burn-blast injuries through suppressing an excessive release of ICAM-1 and PBMC apoptosis in a concentration-dependent manner.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2014年第20期1573-1576,共4页
National Medical Journal of China
基金
首都医学发展科研基金（2009-2040）
关键词
创伤和损伤
二异泊酚
烧冲复合伤
细胞黏附分子
淋巴细胞功能相关抗原1
Wound and injuries
Propofol
Burn-blast combined injuries
Cell adhesion molecules
Lymphocyte function-associated antigen-1
