危重烧伤早期处理
ENGLISH ABSTRACT
不同免疫调节方式对烧伤脓毒症大鼠炎性反应的影响
窦懿
张勤
章雄
董叫云
唐佳俊
廖镇江
作者及单位信息
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Effect of different immunomodulation on inflammatory response in burn rats with sepsis
DOU Yi
ZHANG Qin
ZHANG Xiong
DONG Jiao-yun
TANG Jia-jun
LIAO Zhen-jiang
Authors Info & Affiliations
DOU Yi
ZHANG Qin
ZHANG Xiong
DONG Jiao-yun
TANG Jia-jun
LIAO Zhen-jiang
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摘要

目的了解胸腺素和生长激素对烧伤及烧伤并发脓毒症大鼠炎性反应的影响。方法将SD大鼠按完全随机法分为8组,每组8只。(1)正常对照组。(2)未烧伤脓毒症组:正常大鼠注射LPS。(3)未烧伤脓毒症胸腺素组:正常大鼠先后注射胸腺素和LPS。(4)未烧伤脓毒症生长激素组:正常大鼠先后注射重组人生长激素(rhGH)和LPS。(5)烧伤组。(6)烧伤脓毒症组:大鼠烧伤后注射LPS。(7)烧伤脓毒症胸腺素组:大鼠烧伤后依次注射胸腺素和LPS。(8)烧伤脓毒症生长激素组:大鼠烧伤后依次注射rhGH和LPS。取各组大鼠脾脏组织及外周血标本,检测脾脏淋巴细胞人白细胞DR抗原(HLA—DR)表达情况,观察脾脏炎性细胞浸润情况(计分),测定外周血单核细胞Toll样受体4(TLR4)表达情况及血清TNF-α、IL-4、IL-6、IL-10水平。结果(1)与正常对照组比较,未烧伤脓毒症组大鼠除血清IL-10水平明显降低之外(P〈0.01),其余指标均明显增高(P〈0.01)。未烧伤脓毒症胸腺素组大鼠HLA-DR、TLR4表达及血清TNF—α水平与未烧伤脓毒症生长激素组相近(P〉0.05);但前一组大鼠脾脏炎性细胞浸润程度为(1.50±0.76)分,IL-6、IL-4、IL-10水平分别为(0.0064±0.0012)、(0.0058±0.0024)、(0.0230±0.0021)μg/mg,与后一组大鼠[(2.87±0.04)分,(0.0083±0.0018)、(0.0102±0.0021)、(0.0310±0.0027)μg/mg]比较明显降低(P〈0.01)。(2)烧伤组大鼠HLA-DR、TLR4表达和脾脏炎性细胞浸润程度均明显高于正常对照组而低于烧伤脓毒症组;烧伤组TNF-α、IL-6水平较正常对照组明显增高,IL-4、IL-10明显减少(P〈0.01)。烧伤脓毒症生长激素组HLA—DR及IL-6水平与烧伤脓毒症胸腺素组接近(P〉0.05);但与后组相比,前组大鼠脾脏炎性细胞浸润程度、TLR4表达和TNF-α水平明显降低(P〈0.01),IL-4、IL-10水平明显增高(P〈0.01)。结论有创伤与无创伤条件下,胸腺素与生长激素干预脓毒症过度炎性反应的效果接近;有创伤因素存在时,生长激素更能抑制该炎性反应。

烧伤;脓毒症;生长激素;胸腺素;炎性反应
ABSTRACT

Objective To investigate the effect of Thymosin and growth hormone (GH) on inflammatory response in burn rats or burn rats with sepsis. Methods Sixty-four SD rats were randomly divided into normal control group ( NC, without treatment) , sepsis group ( S, with injection of LPS) , sepsis + Thy- mosin group (ST, with successive injection of Thymosin and LPS), sepsis + GH group [ SGH, with successive injection of recombinant human GH (rhGH) and LPS] , burn group, burn + sepsis group (BS, with injection of LPS after burn) , burn + sepsis + Thymosin group ( BST, with successive injection of Thymosin and LPS after burn) , burn + sepsis + GH (BSGH, with successive injection of rhGH and LPS after burn) , with 8 rats in each group. Specimens of spleen tissues were harvested to determine HLA-DR in lymphocyte and e- valuate inflammatory cell infiltration (score). Specimens of peripheral blood were collected to determine Toll-like receptor 4 (TLR4) level in monocyte and serum level of TNF-α, IL-4, IL-6, IL-10. Results Compared with those in NC group, serum level of IL-10 in S group decreased obviously, while other indices increased obviously ( P 〈 0.01 ). The levels of HLA-DR and TLR4 and serum level of TNF-α were similar between SGH and ST groups ( P 〉0.05). Compared with those in SGH group [(2.87 ±0.04) score, and IL-6 (0.0083 ±0.0018) μg/mg, IL-4 (0.0102±0.0021) μg/mg, IL-10 (0.0310 ±0.0027) μg/mg, respectively] , degree of inflammatory cell infiltration (1.50 ± 0.76) score and serum levels of IL-6, IL-4,IL-10 of rats in ST group decreased obviously (0. 0064± 0. 0012, 0. 0058 ±0. 0024, 0. 0230 ± 0. 0021 μg/mg, respectively, P 〈0.01 ). The levels of HLA-DR, TLR4 and inflammatory cell infiltration degree of spleen in B group were respectively higher than those in NC group and lower than those in BS group. Compared with those in NC group, serum levels of TNF-α, IL-6 in B group increased significantly, while IL-4, IL-10 showed an opposite tendency. There was no obvious difference between BST and BSGH groups in serum levels of HLA-DR and IL-6 ( P 〉 0.05 ). Compared with those in RST group, inflammatory cell infiltration degree in spleen and the levels of TLR, TNF-α obviously decreased ( P 〈 0.01 ) , while IL-4 and IL-10 levels increased in BSGH group ( P 〈0.01 ). Conclusions Inhibitive effects between Thymosin and GH on extensive inflammatory reaction were similar with or without trauma, and GH has better effect as compared with Thymosin when with trauma.

Burns;Sepsis;Growth hormone;Thymosin;Inflammatory response
引用本文

窦懿,张勤,章雄,等. 不同免疫调节方式对烧伤脓毒症大鼠炎性反应的影响 : [J]. 中华烧伤杂志,2009,25(04):275-280.

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