[颈髓切断术对脂多糖诱导的内毒素休克大鼠全身炎症反应及预后的影响]

Zhu Xi, Lin Ying, He Yu, Yin Cheng-hong, Wang Zong-yu, Zhao Hua, Nie Zhi-pin

Department of Surgical Intensive Care Unit, Beijing University, Third Hospital, Beijing 100083, China.

Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2008 Aug;20(8):486-9.

OBJECTIVE

To investigate the effects of cervical chordotomy on systemic inflammatory response and the outcome in rats with endotoxemia induced by lipopolysaccharide (LPS).

METHODS

Ninety-two Sprague Dawley (SD) rats were randomly divided into three groups: normal control group (group I, n=8) , endotoxemia group (group II, n=42) and endotoxemia with cervical chordotomy (group III, n=42). Endotoxemia was induced by intra-peritoneal injection of LPS 10 mg/kg. In group III, "cervical chordotomy" was attained by transection of spinal cord at C7 immediately before intra-peritoneal LPS administration. Ten rats of group II and III each were observed for 48-hour survival. The other rats were further divided into four subgroups of 8 animals each, according to the time when the animals were sacrificed . The animals were sacrificed at 3, 6, 12, and 48 hours after intra-peritoneal LPS injection. Heart blood samples were obtained for determination of plasma concentration of norepinephrine [NE, by high performance liquid chromatography (HPLC)] and plasma concentration of interleukin-10 (IL-10) and IL-6 [by enzyme linked immunosorbent assay (ELISA)].

RESULTS

Plasma NE concentration were significantly increased after intra-peritoneal LPS injection in group II and III as compared with group I and were significantly lower in group III than in group II starting from 6 hours after LPS (all P<0.05). Plasma IL-10 concentration was significantly lower at 3 hours and 6 hours while plasma IL-6 concentration was significantly higher after LPS challenge in group II than in group I at all time points (all P<0.05). High transection of spinal cord significantly elevated plasma IL-10 level at 12 hours and 48 hours, lowered IL-6 release at 3, 6, and 12 hours (all P<0.05), and improved 48-hour survival (20% vs. 70%) in group III as compared with group II.

CONCLUSION

Transection of spinal cord at C7 level can ameliorate the systemic inflammatory response induced by endotoxemia thus improving the outcome through elevation in IL-10 level, decreases in IL-6 release, and improves 48-hour survival. This might be attributable to loss of sympathetic nerve function.

目的

研究颈髓切断术对内毒素血症大鼠全身炎症反应及预后的影响。

方法

将92只Sprague Dawley（SD）大鼠随机分为三组：正常对照组（I组，n = 8）、内毒素血症组（II组，n = 42）和内毒素血症伴颈髓切断术组（III组，n = 42）。通过腹腔注射10 mg/kg脂多糖（LPS）诱导内毒素血症。在III组中，于腹腔注射LPS前立即在C7水平横断脊髓以实施“颈髓切断术”。观察II组和III组各10只大鼠48小时的存活情况。其他大鼠根据处死时间进一步分为四个亚组，每组8只动物。在腹腔注射LPS后3、6、12和48小时处死动物。采集心脏血液样本，通过高效液相色谱法（HPLC）测定去甲肾上腺素（NE）血浆浓度，通过酶联免疫吸附测定法（ELISA）测定白细胞介素-10（IL-10）和白细胞介素-6（IL-6）血浆浓度。

结果

与I组相比，II组和III组腹腔注射LPS后血浆NE浓度显著升高，且从LPS注射后6小时起，III组血浆NE浓度显著低于II组（所有P < 0.05）。LPS攻击后，II组在3小时和6小时时血浆IL-10浓度显著降低，而在所有时间点II组血浆IL-6浓度均显著高于I组（所有P < 0.05）。脊髓高位横断显著提高了III组在12小时和48小时时的血浆IL-10水平，降低了3、6和12小时时IL-6的释放（所有P < 0.05），与II组相比，III组48小时存活率提高（20%对70%）。