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目的 :观察 3 2例多脏器功能不全综合征 (MODS)患者及MODS模型大鼠外周血急性期蛋白 (APP)水平及通里攻下治疗对其影响 ,同时观察体外经大肠杆菌内毒素活化的大鼠肝细胞分泌APP水平及大承气汤对大鼠肝细胞合成分泌APP的影响。方法 :抗原抗体反应比浊法测定上述标本中C反应蛋白 (CRP)、α1 酸性糖蛋白 (α1 AGP)、α1 蛋白酶抑制剂 (α1 AT)、α2 巨球蛋白 (α2 MG)、铜蓝蛋白 (Cp)、触珠蛋白 (Hp)、及转铁蛋白 (Tf)水平。 结果 :MODS患者血清APP水平较对照组显著升高 (P <0 0 1 ) ,经大承气汤行通里攻下治疗 3日后血清APP水平显著降低 (P <0 0 5 ) ;急性感染性腹膜炎及肠系膜动脉缺血再灌注所致MODS大鼠血清APP水平均显著高于对照组 (P <0 0 1 ) ,予大承气汤灌胃治疗 3日后血清APP水平降低 (P <0 0 5 ) ;体外培养大鼠肝细胞经LPS刺激活化后分泌APP水平升高 ,经与不同浓度含大承气汤有效吸收成分兔血清共育后 ,APP的分泌水平下降 ,各APP均呈剂量相关抑制作用。结论 :通里攻下法能降低致损因子对肝脏的刺激作用 ,抑制过度炎症反应对组织脏器的损害。
OBJECTIVE: To observe the effect of acute phase protein (APP) in patients with multiple organ dysfunction syndrome (MODS) and MODS model rats and the effect of Tongli attack on them, and to observe the activation of E. coli in vitro. The level of APP secreted by rat hepatocytes and the effect of Dachengqi Decoction on the synthesis and secretion of APP in rat hepatocytes. Methods: The antigen-antibody reaction turbidimetric method was used to determine the C-reactive protein (CRP), α1 acid glycoprotein (α1 AGP), α1 protease inhibitor (α1 AT), α2 macroglobulin (α2 MG), ceruloplasmin ( Cp), Haptoglobin (Hp), and Transferrin (Tf) levels. Results: The level of APP in the serum of patients with MODS was significantly higher than that of the control group (P < 0.01). After 3 days of treatment with Dachengqi Decoction, the serum APP level was significantly decreased (P <0 05); The levels of APP in peritonitis and MODS rats induced by ischemia and reperfusion of mesenteric artery were significantly higher than those in the control group (P < 0.01). The level of APP in Dachengqi Decoction was reduced after 3 days of intragastric administration (P <0 0 5). In vitro cultured rat hepatocytes were stimulated by LPS to increase the secretion of APP. After culturing with different concentrations of rabbit serum containing effective absorption of Dachengqi Decoction, the secretion of APP decreased, and each APP showed dose-related inhibition. effect. Conclusion : The Tongli attack method can reduce the irritative effect of the damage factor on the liver and inhibit the damage of the excessive inflammatory reaction to the tissue organs.