早期高容量短时血液滤过对重症急性胰腺炎犬血浆细胞因子的影响.pdfVIP

· 40· 江西医学院学报 2007年第47卷第6期 ActaAcademiae Medicinae Jiangxi 2007，Vol 47，No6 早期高容量短时血液滤过 对重症急性胰腺炎犬血浆细胞因子的影响 曾 皓，夏 亮，吕农华，舒宏春 (南昌大学第一附属医院消化科，南昌330006) 摘要：目的 观察早期高容量短时血液滤过(EHSVVH)对重症急性胰腺炎(SAP)犬血浆中TNF-a、IL一6和IL一1o 的影响。方法 采用逆行胰胆管内注射 5 牛磺胆酸钠法建立 SAP模型。随机分为对照组(A组)和治疗组(B 组)，A组用单纯呼吸机治疗+假治疗(血液在滤器内循环，不接置换液，不超滤)；B组用机械通气+高容量血液滤 过治疗，以前稀释方式输入超滤液。监测造模前、造模后及治疗2、4、6 h血浆TNF_a、IL一6、IL一10水平，观察胰腺组 织学变化。结果 与A组相比，B组 4、6 h血浆 TNF_a、IL-6较低(PO，O1)，而II 一1O水平于B组4 h出现一波峰 (PO．05)；两组胰腺病理学评分无显著差别(PO．05)。结论 ESHVVH可有效降低 SAP犬血浆中的促炎因 子TNF-a、IL-6的水平；升高抗炎因子IL-10，从而纠正促炎因子和抗炎因子失衡。有望成为临床早期治疗及预防 SAP合并多脏器功能障碍综合征的有效方法。 关键词：重症急性胰腺炎；多脏器功能障碍综合征；血液滤过；肿瘤坏死因子一n；白介素一6；白介素一lo 中图分类号：R-332 文献标识码：A 文章编号：1000～2294(2007)06一O04o—o5 Effect of Early Short-·term High-。volume Hemofiltration on Serum Cytokines of the Dogs with Severe Acute Pancreatitis ZENG Hao，XIA Liang，LV Nong-hua，SHU Hong-chun (Department of Gastrointeseinal Medicine，the First Affiliated Hospital of Nanchang University，Nanchang 330006，China) ABSTRACT：Objective To investigate the effect of early short time high volume venovenous he- mofiltration(ESHVVH)on plasma level of TNF—a、IL一6、IL一10，pancreas injury．Methods SAP models were established by retrograde injection of 5 sodium taurocholate into the main pancre- atic duct under the surgery．Sixteen healthy hybrid dogs were randomly allocated into groups A and B．The animals in group A received the treatment of ESHVVH，while Group B was just a control group．Blood samples were collected at the same points(before and 0 hour，2 hour，4hour， 6hour after the induction of severe acute pancreatitis)，plasma concentrations of TNF-a，IL-6，IL- 1 0 were measured．The specimens of pancreas were collected for hi