抑制应激对烧伤血浆中LPS、前炎症细胞因子和TH1/TH2细胞因子的影响

目的 探讨抑制机体应激反应的措施，对严重烧伤后血浆中LPS、前炎症细胞因子和Th1/Th2细胞因子的影响。方法 将30％TBSA深Ⅱ度烧伤模型的SD大鼠分为烧伤立即复苏组（A）和烧伤立即复苏合剂组（B），于伤后不同时相点取外周血分离血浆检测LPS、IL－1α、IL-6、TNFα、IL-8和IL－2、IFN－γ、IL－4、IL－10含量，另设假烧组作为对照（C）。结果 伤后LPS、IL－1α、IL－4、IL－10水平逐渐升高，IL－6、TNF－α、IL－8、IL－2和IFN－γ水平先升高后下降。A组炎症细胞因子和LPS升高幅度较大，其中IL－1α、IL－6和IL－4等升高时间（6h）较B组（12h）早。结论 及时液体复苏和采取抑制应激的措施，能延缓并减轻严重烧伤后炎症反应的发生，降低Th2细胞因子水平并使烧伤48h后Th1细胞因子得到部分恢复。

The Influence of stress inhibition on the plasma levels of LPS, pro-inflammatory and Th1/Th2 cytokines in severely scalded rats

OBJECTIVE: To explore the influence of stress inhibition on the plasma levels of LPS pro-inflammatory and Th1/Th2 cytokines in severely scalded rats. METHODS: Sprague-Dawley (SD) rats inflicted by 30% TBSA of deep partial thickness burn were employed as the model and randomly divided into burn with immediate resuscitation (A) and burn with immediate resuscitation and soluble cocktail (B) groups. Plasma was harvested from peripheral blood at different postburn time points for the determination of the levels of LPS, IL-1alpha, IL-6, TNFalpha, IL-8, IL-2, IFN-gamma, IL-4 and IL-10 in the rats of the two groups. And the rats inflicted by sham scalding were taken as control group (C). RESULTS: The postburn plasma levels of LPS, IL-1alpha, IL-4 and IL-10 increased gradually, while the plasma levels of IL-6, TNF, IL-8, IL-2 and IFN increased initially and decreased thereafter. The increasing ranges of LPS and these inflammatory cytokines were higher in A group, in which the increases of IL-1alpha, IL-6 and IL-4 appeared earlier in A (6 PBH) than those in B (12 PBH) groups. CONCLUSION: Prompt fluid resuscitation and stress inhibition could delay and ameliorate the postburn inflammatory reaction, decrease the production of Th2 cytokine and partially restore the production of Th1 cytokine after 48 PBH.