Yamada Y, Endo S, Kasai T, Koike S, Takakuwa T, Inoue Y, Niimi M, Endo Y, Wakabayashi G, Inada K
Critical Care and Emergency Center, Iwate Medical University, Morioka, Japan.
Res Commun Mol Pathol Pharmacol. 1998 Apr;100(1):92-104.
Nuclear matrix protein (NMP), an indicator of apoptosis, was analyzed in patients with multiple organ dysfunction syndrome (MODS). Blood levels of tumor necrosis factor-alpha (TNF-alpha) and nitrite/nitrate (NOx) were also measured in these patients to determine the involvement of these factors in the production of NMP. Forty-six patients with MODS were studied, 21 (45.7%) of whom died. NMP and TNF-alpha were measured by enzyme-linked immunosorbent assay (ELISA). NOx was measured by the Griess's method. Marshall's multiple organ dysfunction score (MOD score) was used as an indicator of organ failure. The severity of organ failure was assessed by use of the acute physiology and chronic health evaluation II score (APACHE II score). The number of organs that failed was found to be significantly correlated with the NMP level. The NMP level was also correlated significantly with MOD score and APACHE II score, as well as with TNF-alpha and NOx levels. NMP and NOx levels in the group that died significantly exceeded those in the surviving group. Results suggest that apoptosis can occur in the presence of MODS, and that its extent increases as the number of failing organs increases. The results also suggest that TNF-alpha and NO are involved in the induction of apoptosis.
对多器官功能障碍综合征（MODS）患者的核基质蛋白（NMP，一种细胞凋亡指标）进行了分析。还测定了这些患者血液中的肿瘤坏死因子-α（TNF-α）和亚硝酸盐/硝酸盐（NOx）水平，以确定这些因子在NMP产生中的作用。对46例MODS患者进行了研究，其中21例（45.7%）死亡。采用酶联免疫吸附测定（ELISA）法测定NMP和TNF-α。采用格里斯法测定NOx。采用马歇尔多器官功能障碍评分（MOD评分）作为器官衰竭的指标。采用急性生理与慢性健康状况评价II评分（APACHE II评分）评估器官衰竭的严重程度。发现衰竭器官的数量与NMP水平显著相关。NMP水平还与MOD评分、APACHE II评分以及TNF-α和NOx水平显著相关。死亡组的NMP和NOx水平显著高于存活组。结果表明，MODS患者可发生细胞凋亡，且随着衰竭器官数量的增加，细胞凋亡程度加重。结果还表明，TNF-α和NO参与了细胞凋亡的诱导。
