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目的:探讨内毒素和细胞因子在腹部火器伤肠管穿透后血液中的变化规律及意义。方法:健康长白仔猪42头随机等分为对照组和伤后1h、2h、4h、8h、12h和24h组,实验组建立腹部火器伤肠管穿透模型后,用显色基质鲎试剂法检测各组血浆内毒素水平,采用双抗体夹心ELISA法测定各组动物血清TNF-α、IL-6水平,并观察各个时间点的体温变化。结果:实验各组的血浆内毒素水平及血清TNF-α、IL-6水平均明显高于对照组(P<0.05),血浆内毒素于伤后8h达到高峰,伤后12h仍维持在高峰值水平(P<0.05);血清TNF-α在伤后12h为(94.36±10.18)ng/L,IL-6在伤后12h为(1218.35±74.00)ng/L,二者均于伤后12h达到高峰并与伤后血浆内毒素水平变化一致。伤后动物体温逐渐升高,在伤后12h、24h实验组的平均体温达40℃以上。结论:腹部火器伤肠穿孔后内毒素血症可能诱导了血液中TNF-α、IL-6的产生,并参与了腹部肠管火器伤后机体的病理生理过程。
Objective: To investigate the changes and significance of endotoxin and cytokines in the blood after intestine firearm wound. Methods: Forty-two healthy Changbai pigs were randomly divided into control group and 1h, 2h, 4h, 8h, 12h and 24h after injury. The experimental group was established abdominal firearm intestinal perforation model, Plasma levels of endotoxin were measured. Serum TNF-α and IL-6 levels were measured by double antibody sandwich ELISA. The changes of body temperature at different time points were observed. Results: The levels of plasma endotoxin and the levels of serum TNF-α and IL-6 in the experimental groups were significantly higher than those in the control group (P <0.05). The plasma endotoxin peaked at 8h after injury and remained at a peak at 12h (94.36 ± 10.18) ng / L at 12 h after injury, and (1218.35 ± 74.00) ng / L at 12 h after IL-6 injury, both of which reached the level of 12 h after injury Peak and with changes in plasma endotoxin levels consistent. Animal body temperature gradually increased after injury, 12h after injury, 24h experimental group average body temperature of 40 ℃ or more. CONCLUSION: Endotoxemia after intestinal perforation of abdomen firearm may induce the production of TNF-α and IL-6 in the blood and participate in the pathophysiological process of the body after abdominal firearm wound.