论文标题:红细胞免疫功能及相关细胞因子在高容量血液滤过防治多器官功能障碍中的变化及意义
The Changes and Significance of Erythrocyte Immune Function and Relating Cytokines in Multiple Organ Dysfunction Prevented or Treated with High Volume Hemofiltration
论文作者 张旭魁
论文导师 方国恩；毕建威,论文学位 博士,论文专业 普通外科学
论文单位 第二军医大学,点击次数 71,论文页数 99页File Size9578k
2005-05-01论文网 http://www.lw23.com/lunwen_118996592/ 多器官功能障碍综合征;高容量血液滤过;红细胞免疫;细胞因子
multiple organ dysfunction syndrome ; high volume hemofiltration;erythrocyte immunity ; cytokines
目的 探讨高容量血液滤过防治多器官功能障碍综合征中的红细胞免疫功能及相关细胞因子的变化及意义。方法27头猪随机分为对照组、MODS组及HVHF组,监测各主要脏器功能,测定红细胞CR1天然免疫粘附能力(ENIAF)、红细胞趋化因子受体(ECKR)结合活性及血浆和超滤液中TNFα、IL-1β、IL-6、IL-8、IL-10浓度变化。结果 与MODS组相比,HVHF组各主要脏器功能指标明显改善,MODS的发生率和死亡率显著降低,滤过治疗后ENIAF和ECKR结合活性下降幅度明显趋缓;HVHF组各促炎因子血浆水平明显下降,与MODS组相比有显著差异(P<0.01);除TNFα外,IL-1β、IL-6、IL-8、IL-10均在超滤液中检测到。结论HVHF能有效改善各主要脏器功能,降低血浆细胞因子水平,改善红细胞免疫,从而促进红细胞对IL-8等炎症因子的调控,改善机体的免疫状态。
Objective To investigate the changes and significance of erythrocyte immune function and relating cytokines in multiple organ dysfunction prevented or treated with high volume hemofiltration(HVHF). Methods 27 pigs were divided randomly into three groups(group C, group MODS, group HVHF).Major organs function were monitored. Erythrocyte natural immune adherence function(ENIAF) and erythrocyte chemokine receptor(ECKR) were detected by rosette formation test and enzyme-linked immunosorbent assay(ELISA), respectively. Plasma and ultrafiltrate concentrations of TNF α IL-1β IL-6 IL-8 IL-10 were measured. Results The functions of major organs in group HVHF improved obviously,and the MODS morbidity and mortality reduced significantly,compared with that in group HVHF. ENIAF and ECKR combining activity in group HVHF decreased much slowly through the treatment or HVHF than that in group MODS(P < 0.01). After hemofiltration the plasma levels of TNF α IL-1β IL-6 IL-8 in group HVHF descended significantly compared with those in group MODS (P<0.01).Except TNF α , IL-1β .IL-6 IL-8 and IL-10 were detectable in ultrafiltrate. Conclusion HVHF may effectively improve the functions of major organs,reduce the plasma concentrations of inflammatory cytokines and improve erythrocyte immunity therefore facilitating the red blood cells to regulate IL-8 and other proinflammatory cytokines,and ameliorating the immune state of the body .
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