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目的观察高容量血液滤过(HVHF)防治家猪多器官功能障碍(MODS)对淋巴细胞凋亡的影响。方法19头猪采用失血性休克+复苏灌注+内毒素血症复制MODS模型,随机分为HVHF组(n=10)和MODS组(n=9)。采用酶联免疫吸附试验(ELISA)检测血清白细胞介素(IL)-1β、IL-10浓度;采用流式细胞仪技术检测淋巴细胞凋亡;采用免疫印迹杂交法检测淋巴细胞膜表面Fas表达。结果HVHF组治疗后IL-1β浓度明显下降;IL-10由治疗开始后即明显下降,至6 h达到最低点,此后维持在稳定状态;淋巴细胞膜表面Fas表达明显下降,淋巴细胞凋亡率逐渐减少。HVHF组各主要器官功能均明显改善,动物死亡率和MODS发生率显著低于MODS组。结论HVHF通过对促炎／抗炎细胞因子平衡的调节,下调了淋巴细胞膜表面Fas表达,减少淋巴细胞凋亡,恢复其功能,从而对MODS起到一定的防治作用。
Objective To observe the effect of high-volume hemofiltration (HVHF) on lymphocyte apoptosis in domestic pigs with multiple organ dysfunction (MODS). METHODS: The MODS model was duplicated in hemorrhagic shock + resuscitation perfusion + endotoxemia in pigs and divided into HVHF group (n = 10) and MODS group (n = 9) at random. Serum levels of IL-1β and IL-10 were detected by enzyme linked immunosorbent assay (ELISA). Apoptosis of lymphocytes was detected by flow cytometry. The expression of Fas on membrane of lymphocytes was detected by immunoblotting. Results The concentration of IL-1β was significantly decreased in HVHF group. IL-10 decreased significantly from the beginning of treatment to the lowest level at 6 h, then remained stable. The expression of Fas on the surface of lymphocytes decreased significantly and the rate of lymphocyte apoptosis gradually increased cut back. The functions of major organs in HVHF group were significantly improved, the incidence of animal mortality and MODS was significantly lower than that of MODS group. Conclusions HVHF can prevent MODS by regulating the balance of proinflammatory / anti-inflammatory cytokines, down-regulating the expression of Fas on the surface of lymphocytes, reducing the apoptosis of lymphocytes and restoring their function.