中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2009年
9期
937-942
,共6页
王恒进%王笑云%张苗%应旭旻%毛慧娟%ZHU Wen-bin%孙琤
王恆進%王笑雲%張苗%應旭旻%毛慧娟%ZHU Wen-bin%孫琤
왕항진%왕소운%장묘%응욱민%모혜연%ZHU Wen-bin%손쟁
生物人工肾%白介索10%肿瘤坏死因子-α%多器官功能障碍综合征%存活时间
生物人工腎%白介索10%腫瘤壞死因子-α%多器官功能障礙綜閤徵%存活時間
생물인공신%백개색10%종류배사인자-α%다기관공능장애종합정%존활시간
Interleukin-10%Tumor necrosis factor-α%Bioartificial kidney%Multiple organ dysfunction syndrome%Survival time
目的 探讨生物人工肾(BAK)对急性肾衰(ARF)合并多器官功能障碍(MODS)猪的细胞因子反应性及存活时间的影响.方法 17只ARF并MODS猪模型随机分为三组:BAK组(A组,n=6);假BAK组(B组,n=6),血滤器中不含细胞;未治疗组(C组,n=5).观测平均动脉压、肝肾功能、血清IL-10、TNF-α、动脉血气和牛存时间.两组计量资料的对比采用t检验;三组计量资料的比较采用方差分析.结果 A组治疗24 h平均动脉压(mmHg)显著高于B组、C组[(91.82±5.73)vs.(64.29±13.05)vs.(52.91±3.72),P＜0.01].血清IL-10(pg/mL)的峰值A组明显高于B、C组[(249.57±43.51)vs.(132.06±17.53)vs.(104.25±13.42),P＜0.01].血清TNF-α水平(pg/mL)A组治疗后较治疗前明显降低[(402.91±32.47)vs.(537.16±38.45),P＜0.05];治疗24 h A、B两组间亦有显著差异(P＜0.05).生存时间:A组为(113.01±14.32)h,明显长于B组(83.14±17.68)h和C组(68.95±18.28)h(P＜0.01),A组比B、C组分别延长了35.93%、63.90%.结论 BAK可明显延长MODS合并ARF猪模型的存活时间,可能与BAK显著改善其低血压状况、升高血IL-10水平和降低血TNF-α浓度有关.
目的 探討生物人工腎(BAK)對急性腎衰(ARF)閤併多器官功能障礙(MODS)豬的細胞因子反應性及存活時間的影響.方法 17隻ARF併MODS豬模型隨機分為三組:BAK組(A組,n=6);假BAK組(B組,n=6),血濾器中不含細胞;未治療組(C組,n=5).觀測平均動脈壓、肝腎功能、血清IL-10、TNF-α、動脈血氣和牛存時間.兩組計量資料的對比採用t檢驗;三組計量資料的比較採用方差分析.結果 A組治療24 h平均動脈壓(mmHg)顯著高于B組、C組[(91.82±5.73)vs.(64.29±13.05)vs.(52.91±3.72),P＜0.01].血清IL-10(pg/mL)的峰值A組明顯高于B、C組[(249.57±43.51)vs.(132.06±17.53)vs.(104.25±13.42),P＜0.01].血清TNF-α水平(pg/mL)A組治療後較治療前明顯降低[(402.91±32.47)vs.(537.16±38.45),P＜0.05];治療24 h A、B兩組間亦有顯著差異(P＜0.05).生存時間:A組為(113.01±14.32)h,明顯長于B組(83.14±17.68)h和C組(68.95±18.28)h(P＜0.01),A組比B、C組分彆延長瞭35.93%、63.90%.結論 BAK可明顯延長MODS閤併ARF豬模型的存活時間,可能與BAK顯著改善其低血壓狀況、升高血IL-10水平和降低血TNF-α濃度有關.
목적 탐토생물인공신(BAK)대급성신쇠(ARF)합병다기관공능장애(MODS)저적세포인자반응성급존활시간적영향.방법 17지ARF병MODS저모형수궤분위삼조:BAK조(A조,n=6);가BAK조(B조,n=6),혈려기중불함세포;미치료조(C조,n=5).관측평균동맥압、간신공능、혈청IL-10、TNF-α、동맥혈기화우존시간.량조계량자료적대비채용t검험;삼조계량자료적비교채용방차분석.결과 A조치료24 h평균동맥압(mmHg)현저고우B조、C조[(91.82±5.73)vs.(64.29±13.05)vs.(52.91±3.72),P＜0.01].혈청IL-10(pg/mL)적봉치A조명현고우B、C조[(249.57±43.51)vs.(132.06±17.53)vs.(104.25±13.42),P＜0.01].혈청TNF-α수평(pg/mL)A조치료후교치료전명현강저[(402.91±32.47)vs.(537.16±38.45),P＜0.05];치료24 h A、B량조간역유현저차이(P＜0.05).생존시간:A조위(113.01±14.32)h,명현장우B조(83.14±17.68)h화C조(68.95±18.28)h(P＜0.01),A조비B、C조분별연장료35.93%、63.90%.결론 BAK가명현연장MODS합병ARF저모형적존활시간,가능여BAK현저개선기저혈압상황、승고혈IL-10수평화강저혈TNF-α농도유관.
Objective To study the effects of bioartificial kidney(BAK)treatment on cytokines interleukin-10(IL-10)and tumor necrosis factor-α(TNF-α),biochemistry indexes,and survival time in acute uremic pigs with multiple organ dysfunction syndrome(MODS).Method Pigs with MODS and acute renal failure(ARF)were treated with BAK(group A,n = 6)or sham BAK containing no cells(group B,n = 6)or received no treatment(group C,n = 5).Data on blood pressure,hepatic and renal functions,serum IL-10 and TNF-α levels,arterial blood gas and survival time of all the pigs were recorded.Comparisons of values were done using Student's t-test or repeated-measures analysis of variance(ANOVA).ResultsMean arterial pressure(MAP,mmHg)responsed more rapidly and reached higher values in group A (91.82±5.73)compared with group B and C at 24 hours(P＜0.01).The peak level of serum EL-10(pg/mL)ingroupA(249.57±43.51)was significantly higher than that in group B and C(132.06± 17.53,104.25 ±13.42,P＜0.01).Serum TNF-a level(pg/mL)in group A dropped gradually to(402.91 ± 32.47)at 24 hours,and had significant discrepancy compared with that before the treatment(537.16 ± 38.45)and that in groupB(P＜0.05).The average survival time(hours)in group A(113.01 ± 14.32)was significantly longer than that in the group B and C(P＜0.01),which was prolonged by 35.93%and 63.90%,respectively.ConclusionsTreatment with BAK can prolong the survival time of uremic pigs with MODS,possibly through ameliorating the MAP,increasing the level of IL-10 and reducing the concentration of TNF-α.
