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目的探讨高容量血液滤过(HVHF)治疗对脓毒症伴急性肾衰竭犬模型血清及肝、肺、肾组织炎症因子高迁移率族蛋白1(HMGB1)、TNF-α、IL-6的影响。方法 12只雄性Beagle犬双侧输尿管结扎后静脉注射内毒素(LPS)1.0mg/kg,制作脓毒症伴急性肾衰竭犬模型。随机均分为模型组和HVHF组(注射LPS后立即行HVHF治疗24h)。注射LPS前及注射后2、4、8、16、24h取静脉血检测血常规、肝肾功能、电解质,注射LPS前及注射后24h行动脉血气分析,ELISA法检测各时间点血清及注射后24h肝、肺、肾组织上清液中HMGB1、TNF-α、IL-6的浓度。结果与模型组相比,HVHF组血清HMGB1、TNF-α、IL-6的峰值及维持值降低,HMGB1达峰时间延迟,肝、肺、肾组织上清液中HMGB1、TNF-α、IL-6浓度降低,肝、肺、肾功能改善(P<0.05)。结论 HVHF可以降低脓毒症伴急性肾衰竭犬血清及肝、肺、肾组织炎症因子浓度,保护肝、肺、肾功能。
Objective To investigate the effects of high-volume hemofiltration (HVHF) treatment on the serum levels of HMGB1, TNF-α and IL-6 in serum, liver, lung and kidney tissue of septic rats with acute renal failure . Methods Bilateral ureter of 12 male Beagle dogs were intravenously injected with 1.0 mg / kg of endotoxin (LPS) to make a model of sepsis and acute renal failure in dogs. Randomly divided into model group and HVHF group (HVHF treatment immediately after LPS injection). Venous blood was collected before LPS injection and at 2, 4, 8, 16, and 24 hours after injection for blood, liver and kidney function, electrolytes, arterial blood gas analysis before and 24 h after injection of LPS, serum and post- 24h liver, lung, kidney tissue supernatant HMGB1, TNF-α, IL-6 concentration. Results Compared with the model group, the peak and maintenance values of serum HMGB1, TNF-α and IL-6 in HVHF group were decreased and the peak time of HMGB1 was delayed. The levels of HMGB1, TNF-α and IL- 6 decreased, liver, lung and kidney function improved (P <0.05). Conclusions HVHF can reduce the concentration of inflammatory cytokines in serum, liver, lung and kidney of sepsis patients with acute renal failure and protect liver, lung and kidney.