p38MAPK和COX-2mRNA在创伤后多器官功能障碍综合征患者外周血中的表达

目的 探讨创伤后多功能障碍综合征(multiple organ dysfunction syndrome,MODS)患者外周血单核细胞(peripheral blood mononuclear cells,PBMCs)环氧化酶-2(cyclooxygenase-2,COX-2)与p38丝裂原活化蛋白激酶(p38 mitogen-activated protein kinase,p38MAPK)mRNA的表达以及与MODS病情变化的关系.方法 选择符合1995年中华医学会急诊分会危重病专业组制定的MODS病情分期诊断标准和1991年Knaus提出急性生理和慢性健康评分Ⅲ(APACHE Ⅲ)的患者40例,其中男22例,女18例;与患者年龄、性别相匹配的健康对照组40名.用酶联免疫吸附试验法(ELISA)检测PBMCs培养上清液COX-2与p38MAPK含量;用逆转录-聚合酶链反应(RT-PCR)法检测PBMCs中COX-2与p38MAPK的mRNA表达.并分析它们的表达与APACHEⅢ评分的相关性.结果 MODS组患者PBMCs的COX-2与p38MAPK含量及两者的mRNA表达均显著高于健康对照组(均P<0.05);MODS死亡患者PBMCs的COX-2与p38MAPK含量及两者的mRNA表达与存活患者比较,差异具有统计学意义(均P<0.05);相关分析显示,PBMCs培养上清液中COX-2与p38MAPK含量呈正相关(r=0.614 7,P<0.01);患者 PBMCs的COX-2和p38MAPK mRNA表达与APACHEⅢ评分呈正相关(r1=0.500 9,P1<0.05,r2=0.531 6,P2<0.05).结论 COX-2与p38MAPK参与了MODS的发病过程,而且可作为判断MODS预后的辅助指标.

Abstract：

Objective To explore the expression of COX-2 and p38MAPK in patients with trauma MODS. Methods Forty MODS patients were evaluated. The levels of peripheral blood mononuclear cells COX-2 and p38MAPK in MODS patients and 40 normal controls was detected by enzyme linked immunosor-bent assay (ELISA). RT-PCR was used to measure the COX-2 mRNA and p38MAPK mRNA expression of in PBMCs. ANOV and correlation analysis were used in statistical analysis. Results The levels of COX-2 and p38MAPK of PBMCs and the mRNA expression in MODS group were higher than in control group (all P <0.05). The levels of COX-2 and p38MAPK of PBMCs and the mRNA expression in dead group were higher than in survival group( all P <0.05). The levels of COX-2 and p38MAPK of PBMCs were positively correlated, (r =0.6 147, P<0.01). The expression of COX-2 mRNA, p38MAPK mRNA of PBMCs and APACHE I scoring were positively correlated (r1 =0.5 009, P1 <0.05,r2 =0. 5 316, P2 <0. 05). Conclusions COX-2 and p38MAPK of PBMCs take part in the onset of MODS, and may service as index to judge the prognosis of MODS.

Expression of COX-2 and p38MAPK of peripheral blood mononuclear cells in trauma patients with multiple organ dysfunction syndrome

Objective To explore the expression of COX-2 and p38MAPK in patients with trauma MODS. Methods Forty MODS patients were evaluated. The levels of peripheral blood mononuclear cells COX-2 and p38MAPK in MODS patients and 40 normal controls was detected by enzyme linked immunosor-bent assay (ELISA). RT-PCR was used to measure the COX-2 mRNA and p38MAPK mRNA expression of in PBMCs. ANOV and correlation analysis were used in statistical analysis. Results The levels of COX-2 and p38MAPK of PBMCs and the mRNA expression in MODS group were higher than in control group (all P <0.05). The levels of COX-2 and p38MAPK of PBMCs and the mRNA expression in dead group were higher than in survival group( all P <0.05). The levels of COX-2 and p38MAPK of PBMCs were positively correlated, (r =0.6 147, P<0.01). The expression of COX-2 mRNA, p38MAPK mRNA of PBMCs and APACHE I scoring were positively correlated (r1 =0.5 009, P1 <0.05,r2 =0. 5 316, P2 <0. 05). Conclusions COX-2 and p38MAPK of PBMCs take part in the onset of MODS, and may service as index to judge the prognosis of MODS.