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目的观察二次打击致脓毒症大鼠血清血小板生成素(TPO)水平的改变,并初步探讨脓毒症时血清 TPO 水平与脓毒症严重程度的关系。方法将 SD 大鼠分成健康对照组(A,n=10)、手术对照组(B,n=8)、脓毒症组(C,n=15)、严重脓毒症组(D,n=12)和脓毒性休克组(E,n=8)。通过低血容量休克打击后注射不同剂量(1mg/kg、2mg/kg、3mg/kg)大肠杆菌内毒素(LPS)复制脓毒症、严重脓毒症及脓毒性休克模型。24h 后测定大鼠血小板计数和血清 TPO、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平。结果脓毒症组血小板较健康对照组无明显变化,严重脓毒症组和脓毒性休克组血小板计数下降显著(P<0.01)。TPO 水平在脓毒症组开始升高,在严重脓毒症组和脓毒性休克组显著升高水平(P<0.01)。IL-6、TNF-α在脓毒症组、严重脓毒症组和脓毒性休克组逐渐升高。多元线性回归分析显示:TPO 与 IL-6密切相关(r=0.832,P<0.00)。结论脓毒症大鼠血清 TPO 水平升高,脓毒症严重程度是 TPO 水平主要决定因素,TPO 水平可作为脓毒症严重程度的生物学标志。
Objective To observe the changes of serum thrombopoietin (TPO) level in septic rats after secondary shock and to explore the relationship between serum TPO level and sepsis severity in sepsis. Methods The SD rats were divided into healthy control group (A, n = 10), operation control group (B, n = 8), sepsis group (C, n = 15), severe sepsis group 12) and septic shock (E, n = 8). Sepsis, severe sepsis and septic shock were replicated by injecting different doses (1mg / kg, 2mg / kg, 3mg / kg) of E. coli lipopolysaccharide (LPS) After 24 hours, the platelet count and serum levels of TPO, IL-6 and TNF-α were determined. Results There was no significant change of platelet in sepsis group compared with healthy control group. The platelet counts of severe sepsis group and septic shock group decreased significantly (P <0.01). TPO levels began to increase in the sepsis group and significantly increased in the severe sepsis group and septic shock group (P <0.01). IL-6 and TNF-α gradually increased in sepsis group, severe sepsis group and septic shock group. Multiple linear regression analysis showed that TPO was closely related to IL-6 (r = 0.832, P <0.00). Conclusions Serum TPO levels in septic rats are elevated. The severity of sepsis is the main determinant of TPO level. TPO level may serve as a biomarker for the severity of sepsis.