摘要
目的了解环氧化酶(COX)和血小板活化因子(PAF)在全身炎症反应综合征(SIRS)与多器官功能障碍综合征(MODS)患者发病机制中的作用。方法选择28例符合美国胸科医师协会/危重病医学会(ACCP/SCCM)提出的SIRS和MODS诊断标准患者,其中SIRS组13例,MODS组15例,另以与患者年龄、性别相匹配的11名健康体检者作为正常对照组。采用淋巴细胞分离液密度梯度离心法分离外周血单核细胞(PBMCs);用酶联免疫吸附法(ELISA)检测PBMCs中COX2含量与血小板活化因子乙酰水解酶(PAF AH)活性;用逆转录聚合酶链反应(RT PCR)法检测PBMCs中COX2与PAF AH的mRNA表达。结果MODS组患者PBMCs中COX2含量、PAF AH活性及两者的mRNA表达均显著高于正常对照组和SIRS组(P均<0.05),正常对照组与SIRS组间差异无显著性,死亡患者高于存活患者(P均<0.05);3组PBMCs中COX2含量与PAF AH活性间呈正相关关系(r=0.329,P<0.05)。死亡患者的外周血白细胞计数、淋巴细胞计数、氧合指数与存活患者比较差异均无显著性,血糖、血肌酐则明显高于存活患者(P<0.05和P<0.01),CO2总含量(TCO2)、动脉血pH值均明显低于存活患者(P均<0.01)。结论COX2与PAF AH参与了MODS的发病过程,而且可作为判断SIRS与MODS预后的参考指标;血糖、肌酐、TCO2、pH可作为判断病情及预后的其他参考指标。
Objective To study the role of cycloxygenase （COX） and platelet-activating factor （PAF）in pathophysiologic mechanisms of patients with systemic inflammatory response syndrome （SIRS） and multiple organ dysfunction syndrome （MODS）. Methods Twenty-eight adult patients whose diagnosis met American college of chest physicians/society of critical care medicine （ACCP/SCCM） criteria for SIRS and MODS were enrolled for study including 13 cases for SIRS group and 15 cases for MODS group. The normal control group consisted of 11 healthy volunteers who matched with study subjects for age and gender. Enzyme linked immunoadsorbent assay （ELISA） was used to measure the content of COX - 2 and the activity of platelet-activating factor acetychydrolase （PAF- AH） of peripheral blood mononuclear cells （PBMCs）. Reverse transcription polymerase chain reaction （RT - PCR） was used to meausure the COX - 2 mRNA and PAF - AH mRNA expression of PBMCs. Results The content of COX - 2 and the activity of PAF - AH of PBMCs and the expression of their mRNA in MODS group were higher than those in SIRS group and control group （all P〈0.05）. There was no significant difference between SIRS group and control group. The content of COX - 2 and the activity of PAF - AH and the expression of their mRNA of PBMCs in non-survivors were higher than those in survived patients （all P〈0. 05）. In 3 groups, positive correlation was found between the COX - 2 content and PAF -AH activity （r= 0. 329, P〈0.05）. The leukocyte count, lymphocyte count, and PaO2/FiO2 of peripheral blood in non-survivors showed no significant difference with those of survived patients （all P〉0. 05）. The blood glucose and creatinine of non-survivors were higher than those of survived patients （P〈0. 05 and P〈0.01）. The total CO2 content （TCO2） and pH value of non-survivors were lower than those of survived patients （both P〈0.01）. Conclusion This study shows that COX - 2 and PAF - AH play a role in the occurrence of
出处
《中国危重病急救医学》
CAS
CSCD
北大核心
2006年第11期687-690,共4页
Chinese Critical Care Medicine
基金
广州市科委重点攻关课题(2001Z13002)
广东省医学科研基金资助项目(A2003176)
