抗TNF单抗对肠缺血诱发多脏器损伤的保护作用

被引：2

作者：

姚咏明

王亚平

于燕

田惠民

徐世豪

盛志勇

赵军

孙世荣

王淑英

机构：

[1] 解放军第三○四医院创伤外科中心

来源：

中华外科杂志 | 1993年 / 08期

关键词：

局部缺血; 肠; 抗体,单克隆; 多器官衰竭;

D O I：

暂无

中图分类号：

R45 [治疗学];

学科分类号：

100215 ;

摘要：

我们采用大鼠肠系膜上动脉阻断模型,初步探讨了抗肿瘤坏死因子单克隆抗体(TNF-MAb)对肠缺血再灌注诱发多脏器损伤的保护作用。结果发现:肠缺血损害早期血浆 TNF 水平即迅速升高,其改变与肠源性内毒素血症、菌血症密切相关;预防性给予 TNF-MAb 后,循环 TNF 水平显著下降,平均动脉压维持于基础值的80%以上,同时肝、肾、肺、凝血等多脏器功能指标均明显改善,体内酸中毒及肠粘膜损害减轻,动物致伤24小时存活率比对照组提高35.7%。该结果提示,TNF 的过度产生、释放可能参与了肠缺血后肠源性感染诱发机体损害的病理生理过程,及早应用 TNF-MAb 可有效地防治宿主脓毒性休克,多脏器损伤甚至衰竭的发生与发展。

引用

页码：497 / 500

共 17 条

[1] EVIDENCE FOR TUMOR NECROSIS FACTOR-INDUCED PULMONARY MICROVASCULAR INJURY AFTER INTESTINAL ISCHEMIA REPERFUSION INJURY [J].

CATY, MG ;

GUICE, KS ;

OLDHAM, KT ;

REMICK, DG ;

KUNKEL, SI .

ANNALS OF SURGERY, 1990, 212 (06) :694-700

[2]

Removal of limulus test-interfering factor in blood samples with perchloric acid and the improvement of the specificity of the limulus test by fractionating amebocyte lysate. Obayashi T,Tamura H,Tanaka S,et al. Progress in Clinical and Biological Research . 1987

[3] EVIDENCE FOR TUMOR NECROSIS FACTOR-INDUCED PULMONARY MICROVASCULAR INJURY AFTER INTESTINAL ISCHEMIA REPERFUSION INJURY [J].

CATY, MG ;

GUICE, KS ;

OLDHAM, KT ;

REMICK, DG ;

KUNKEL, SI .

ANNALS OF SURGERY, 1990, 212 (06) :694-700

[4]

Intestinal diamine oxidase levels reflect ischemic injury. Bragg LE,Thompson JS,West WW. Journal of Surgical Research . 1991

[5]

Monoclonal antibody to tumor necrosis factor a attenuates cardiopulmonary dysfunction in porcine gram-negative sepsis. Walsh CJ,Sugerman HJ,Mullen PG,et al. Archives of Surgery . 1992

[6]

Intestinal diamine oxidase levels reflect ischemic injury. Bragg L E,Thompson J S,West W W. Journal of Surgical Research . 1991

[7]

Antibodies to cachectin/tumor necrosis factor reduce interleukin 1 and interleukin 6 appearance during lethal bacteremia. Fong Y,Tracey KJ,Moldawer LL,et al. The Journal of Experimental Medicine . 1989

[8]

Monoclonal antibody to TNF in severe septic shock. Exley A R,Cohen J,Burman W,et al. The Lancet . 1990

[9]

Antibodies to cachectin/tumor necrosis factor reduce interleukin 1 and interleukin 6 appearance during lethal bacteremia. Fong Y,Tracey KJ,Moldawer LL,et al. Journal of Experimental Medicine, The . 1989

[10]

Tumor necrosis factor(cachectin)in the biology of septic shock syndrome. Tracey KJ. Circulatory Shock . 1991

← 1 2 →