摘要
目的:探讨连续性血液透析滤过(CVVHDF)后多器官功能障碍综合征(MODS)犬肝、肾组织白细胞介素-6(IL-6)和白细胞介素-10(IL-10)mRNA表达水平的变化及意义。方法:15只雄性Beagle犬,采用失血性休克+复苏灌注+内毒素血症复制MODS模型,随机分为CVVHDF组(n=8)和MODS组(n=7),CVVHDF组在内毒素注射完毕后给予CVVHDF治疗12h,MODS组不给CVVHDF治疗。测定各器官功能相关指标,同时应用半定量逆转录-聚合酶链反应(RT-PCR)测定两组肝、肾组织中IL-6、IL-10mRNA表达水平。结果:CVVHDF组治疗后肝、肾功能有关指标水平均有不同程度的改善;与MODS组相比,在内毒素注射后3h及以后各时间点,血清肌酐(Scr)、尿素氮(BUN)水平显著降低(P<0.05);器官衰竭发生率较MODS组明显降低(37.5%vs85.7%,P<0.05);MODS组肝、肾组织IL-6mRNA表达水平显著高于正常对照组和CVVHDF组(P<0.01),而CVVHDF组肝、肾组织IL-10 mRNA表达水平显著高于正常对照组和MODS组(P<0.01)。结论:连续性血液透析滤过能明显改善肾功能,CVVHDF早期应用可以降低MODS肝、肾组织IL-6/IL-10mRNA比值,有助于重建机体免疫系统内稳状态。
Objective： To investigate the effect of continuous veno- venous haemodiafiltration （CVVHDF） on expression of IL - 6 and IL- 10 mRNA in livers and kidneys of a dog with multiple organ dysfunction syndrome （MODS）, Methods：Fifteen Beagle dogs were subjected to hemorrhagic shock plus resusitation and endotoxemia to establish MODS model, then dogs were randomly divided into 2 groups： CVVHDF group （n = 8） and MODS group without CVVHDF （n = 7）. CVVHDF was performed about 12 hours after endotoxin injection in CVVHDF group. Blood samples were taken for evaluation of serum ALT, AST, Cr and BUN. Liver and kidney ,samples of the MODS and CVVHDF groups were immediately collected after the dogs were executed. IL - 6 and IL - 10 mRNA levels were quantified by semi - quantitative RT - PCR. Results： Indices of organ function showed improvement to some extent in CVVHDF group compared with those in MODS group. The levels of Cr,BUN at the 3rd h,6th h,9th h and 12th h during the treatment of CVVHDF were decreased significantly in the CVVHDF group compared with those in the MODS group （P 〈 0.05）. The morbidity of MODS in CVVHDF group was much lower than that in MODS group （37.5 % vs 85.7 %, P 〈 0.05 ）. IL - 6 mRNA levels of liver and kidney tissues in the MODS group were markedly higher than those in the normal control condition and the CVVHDF group （P〈0.01）. IL- 10 mRNA levels in the CVVHDF group were significantly increased,as compared with those in the control condition and the MODS group （ P 〈 0.01 ）. Conclusion： The results suggest that treatment with CVVHDF could effectively improve renal function and decrease IL- 6/IL- 10 mRNA in livers and kidneys, which may potentially reverse immunologic disorder in MODS.
出处
《中国中西医结合肾病杂志》
2008年第7期593-597,共5页
Chinese Journal of Integrated Traditional and Western Nephrology
基金
新疆维吾尔自治区自然科学基金资助项目(No.200821115)
