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目的 观察应用免疫吸附清除循环肿瘤坏死因子 -α(TNF -α)对内毒素休克兔血液循环的影响。 方法 给新西兰白兔一次性静注大肠杆菌内毒素建立内毒素休克动物模型 ,然后将兔随机分为 3组 :(1)对照组 :未行血液灌流 ;(2 )空灌流组 :用空灌流器进行血液灌流 ;(3)免疫吸附组 :用结合抗TNF -α单克隆抗体的免疫吸附灌流器进行血液灌流。对 3组兔进行相应处理后观测其血浆TNF -α活性、血压和微循环变化。 结果 (1)静脉注射内毒素后血浆TNF -α活性迅速升高 ,免疫吸附组 2 ,3 ,6h血浆TNF -α活性明显低于其他两组 (P <0 .0 5 ) ;(2 )注射内毒素导致血压持续性下降 ,免疫吸附治疗后逐渐回升 ;(3)免疫吸附治疗后微循环障碍明显缓解。 结论 免疫吸附清除循环TNF -α可能是一种治疗内毒素休克的有效手段。
Objective To observe the effect of removing circulating tumor necrosis factor-α (TNF-α) on the blood circulation in rabbits with endotoxin shock by immunoadsorption. Methods The animal model of endotoxin shock was established by intravenous injection of E. coli endotoxin in New Zealand White rabbits. The rabbits were randomly divided into 3 groups: (1) control group: no hemoperfusion; (2) (3) Immunoadsorption group: Hemoperfusion was performed with immunosorbent perfusion combined with anti-TNF-α monoclonal antibody. After treatment, the changes of plasma TNF-α, blood pressure and microcirculation were observed. Results (1) The activity of TNF-α in plasma increased rapidly after intravenous injection of endotoxin, and the activity of TNF-α in plasma of 2, 3 and 6 h in the immunoadsorption group was significantly lower than that in the other two groups (P <0.05). (2) Endotoxin lead to persistent decline in blood pressure, immunosuppressive therapy gradually rose; (3) immunosuppressive therapy significantly alleviate microcirculation. Conclusion Immunosorbent clearance of circulating TNF-α may be an effective method for the treatment of endotoxic shock.