摘要
目的:观察早期血液滤过对重症急性胰腺炎(SAP)家猪血浆细胞因子水平和脏器功能的影响。方法:采用胰管逆行灌注人工胆汁法复制家猪SAP模型;随机分为胰腺炎血滤治疗组(HF组,n=8)和胰腺炎非血滤治疗组(NHF组,n=8)。HF组在建模成功后行高容量、零平衡血滤治疗。结果:与NHF组相比,HF组的MAP、CVP及PaO2/FiO2值均较高(P<0.01);心率、尿蛋白含量、血清ALT水平、肺系数与肺湿/干比均较低(P<0.05)。光镜下,HF组肺组织学评分较低(P<0.01);肾、肝组织损伤亦较轻。但胰腺组织学评分在两组间无差异。建模后6h,HF组血浆TNF鄄α、IL鄄1β水平较低(P<0.05);IL鄄10/TNF鄄α比值较高(P<0.05)。结论:早期血滤能有效地廓清SAP猪血浆中的细胞因子TNF鄄α和IL鄄1β,升高IL鄄10/TNF鄄α比值,改善血流动力学,并减轻肺、肾、肝组织损伤。
Objective:To study the effect of early hemofiltration on plasma cytokines levels and organ functions of severe acute pancreatitis(SAP)pigs.Methods:Sixteen SAP pig models were produced by retrograde injection of artificial bile into the pancreatic duct.The animals were divided randomly into2groups:hemofiltration group(HF group,n=8)and non-hemofiltration group(NHF group,n=8).High volume and zero-balanced hemofiltration was performed in the HF group.Results:In comparison to the NHF group,the HF group had higher MAP,CVP and PaO 2 /FiO 2 ratio;and lower HR,6h urinary protein,serum ALT levels,the histological score of lung,lung indexes and lung wet/dry ratio,and milder tissue injury of the kidney and the liver under microscope.At6h after hemofiltration,HF group had lower TNF-αand IL-1βplasma levels and higher IL-10/TNF-αratio.Conclusions:Early hemofiltration can efficiently clear plasma TNF-αand IL-1β,increase IL-10/TNF-αr atio,improve the hemo dynamics,and relieve injuries of the lung,the kidney and the liver of SAP pigs.
出处
《外科理论与实践》
2003年第5期373-375,382,共4页
Journal of Surgery Concepts & Practice
