论文部分内容阅读
目的探讨多脏器功能衰竭(MODS)发病机制及高容量血液滤过(HVHF)防治MOILS的依据。方法采用2次打击法建立猪MODS模型,酶联免疫吸附试验(ELISA)法检测血清干扰素(IFN)-γ和白细胞介素(IL)-4含量变化;逆转录-聚合酶链反应(RT-PCR)法测定脾脏IFN-γ、IL-4 mRNA水平及辅助T细胞特异性转录因子T-bet和GATA-3 mRNA的含量变化。结果HVHF组MODS发生率为20%,显著低于MODS组88.9%(P<0.01);血清IFN-γ和IL-4浓度显著低于MODS组(P<0.05),处死前IFN-γ/IL-4比值明显高于MODS组(P<0.01);脾脏IFN-γ和IL-4 mRNA表达量较MODS组明显下降(P<0.05),IFN-γ/IL-4 mRNA比值明显高于MODS组(P<0.05);脾脏GATA3 mRNA表达量低于MODS组(P<0.01),T-bet mRNA表达量下降,差异无统计学意义(P>0.05),T-bet/GATA3比值显著高于MODS组(P<0.01)。结论Th1向Th2漂移可能是MODS发生的本质原因之一,HVHF能够在一定程度上遏止Th1向Th2漂移的发生。
Objective To investigate the pathogenesis of multiple organ failure (MODS) and the basis of prevention and treatment of MOILS by high-volume hemofiltration (HVHF). Methods The MODS model was established by two-hit method. The levels of serum IFN-γ and IL-4 were detected by enzyme linked immunosorbent assay (ELISA) -PCR method was used to detect the levels of IFN-γ and IL-4 mRNA and the contents of T-bet and GATA-3 mRNA in the spleen. Results The incidence of MODS in HVHF group was 20%, which was significantly lower than that in MODS group (88.9%, P <0.01). The serum IFN-γ and IL-4 levels in HVHF group were significantly lower than those in MODS group -4 was significantly higher than that in MODS group (P <0.01). The expression of IFN-γ and IL-4 mRNA in spleen was significantly lower than that in MODS group (P <0.05) (P <0.05). The expression of GATA3 mRNA in spleen was lower than that in MODS group (P <0.01), while the expression of T-bet mRNA was not significantly different (P> 0.05) Group (P <0.01). Conclusions Th1 to Th2 drift may be one of the essential causes of MODS. HVHF can restrain the Th1 to Th2 drift to a certain extent.