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目的研究应用聚偏氟乙烯(polyvinylidene difluoride,PVDF)-丝氨酸(serine,Ser)吸附膜血液灌流对感染性休克氧化应激和器官功能的影响。方法雄性家猪16头,给予内毒素(lipopolysaccharides,LPS)1μg/kg.h)静脉泵入4 h复制感染性休克模型。随机分为实验组(E组),应用PVDF-Ser吸附膜进行血液灌流2 h;对照组(C组),应用空白灌流器进行血液灌流2 h。于基础期、注射内毒素后和血液灌流后分别测定血浆内毒素浓度、血浆异前列腺素F2(F2-Isoprostane)、血浆硫氧还蛋白(thioredoxin,TRX)和尿液8-羟基-2’-脱氧鸟苷(8-hydroxy-2’-deoxyguanosine,8-OHdG)水平,测定肝肾功能、心肌酶、凝血指标、左心室收缩力指数(index of left ventricular contractility,dPmax)和血管外肺水指数(index of extra-vascular lung water,EVLWI)、动脉血氧分压(arterial partial pressure of oxygen,PaO2);实验结束后测定肺、肝组织还原型谷胱甘肽(glutathione,GSH)含量与髓过氧化物酶(myeloperoxidase,MPO)活力。结果血液灌流后E组F2-Isoprostane、TRX和尿8-OHdG显著低于C组,分别为[(125±54)pg/ml vs(446±101)pg/ml,P=0.004]、[(129±49)ng/ml vs(247±117)ng/ml,P=0.037]、[(10.5±7.3)ng/(mg.Scr)vs(31.1±8.7)ng/(mg.Scr),P=0.016];E组的器官功能指标较C组显著改善;肝、肺组织的GSH含量和MPO活力,组间比较亦存在统计学差异(P<0.05)。结论应用PVDF-Ser吸附膜进行血液灌流,显著减轻感染性休克的氧化应激,从而保护重要器官功能。
Objective To investigate the effect of polyvinylidene difluoride (PVDF) -serine (Ser) membrane on the oxidative stress and organ function of septic shock induced by hemoperfusion. Methods Sixteen male domestic pigs were injected intravenously with lipopolysaccharides (LPS) 1μg / kg.h for 4 hours to duplicate septic shock model. The rabbits were randomly divided into experimental group (group E), PVDF-Ser adsorbed membrane for 2 h, control group (group C), and blank perfusion for 2 h. Plasma endotoxin concentrations, plasma levels of F2-Isoprostane, thioredoxin (TRX), and urine 8-hydroxy-2’- The levels of 8-hydroxy-2’-deoxyguanosine (8-OHdG), liver and kidney function, myocardial enzymes, coagulation index, dpmax and extravascular lung water index (index of extra-vascular lung water, EVLWI) and arterial partial pressure of oxygen (PaO2). After the experiment, the contents of glutathione (GSH) Myeloperoxidase (MPO) activity. Results After hemoperfusion, the levels of F2-Isoprostane, TRX and urine 8-OHdG in group E were significantly lower than those in group C [(125 ± 54) pg / ml vs 446 ± 101 pg / ml, 129 ± 49 ng / ml vs. 247 ± 117 ng / ml, P = 0.037], (10.5 ± 7.3) ng / (mg.Scr) vs. (31.1 ± 8.7) ng / (mg.Scr), P = 0.016]. The indexes of organ function in group E were significantly improved compared with those in group C. The content of GSH and the activity of MPO in liver and lung were also significantly different between groups (P <0.05). Conclusion PVDF-Ser adsorbed membrane is used for hemoperfusion, which can significantly reduce the oxidative stress in septic shock and thus protect the vital organs.