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目的探讨高容量血液滤过(HVHF)防治家猪多器官功能障碍(MODS)对主要炎症细胞:中性粒细胞及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)法检测血清白细胞介素(IL)-1β、IL-10浓度;采用流式细胞仪检测中性粒细胞(PMN)及淋巴细胞的凋亡。结果HVHF组治疗后IL-1β浓度明显下降;治疗开始后IL-10明显下降,6h达到最低点,此后维持在稳定状态。HVHF组治疗后,中性粒细胞凋亡率增加,而淋巴细胞凋亡率下降。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。结论高容量血液滤过能有效降低血浆细胞因子水平,进而加速了中性粒细胞的凋亡,抑制了淋巴细胞凋亡,在一定程度上恢复了机体的免疫平衡,从而对MODS起到防治作用。
Objective To investigate the effect of high-volume hemofiltration (HVHF) on the prevention and treatment of porcine multiple organ dysfunction (MODS) on the main inflammatory cells: neutrophil and lymphocyte apoptosis. 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 neutrophils (PMN) and lymphocytes was detected by flow cytometry. Results The concentration of IL-1β in HVHF group was significantly decreased after treatment. The level of IL-10 in HVHF group decreased significantly and reached the lowest point at 6 hours after treatment. The level remained stable afterwards. After HVHF treatment, the apoptosis rate of neutrophils increased, while the apoptosis rate of lymphocytes decreased. 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. Conclusion High-volume hemofiltration can effectively decrease the level of plasma cytokines, accelerate the apoptosis of neutrophils, inhibit the apoptosis of lymphocytes and restore the immune balance to a certain extent, thus preventing and treating MODS .