小剂量地塞米松对脓毒症大鼠金属基质蛋白酶9等炎症因子的影响

目的探讨建立大鼠盲肠结扎穿刺（CLP）模型,研究地塞米松对炎症因子金属基质蛋白酶9（MMP-9）及肿瘤坏死因子-α（TNF-α）、白介素-6（IL-6）、白介素-8（IL-8）水平变化以及大鼠生存率影响。方法 78只SD大鼠完全随机分为CLP手术组、地塞米松（DEX）0.1 mg/mL治疗组（DEX）,并建立假手术组（Sham）。DEX治疗组在手术完成后立即给予对应剂量的地塞米松。动物成模在各对应时间点取材,检测各组生存率、肺干湿重系数（W/D）,MMP-9及TNF-α、IL-6、IL-8血清水平。结果在使用DEX干预后大鼠生存率有所改善,尚无统计学意义（P〉0.05）。各组炎症介质均出现下降,24 h组IL-6差异有统计学意义（P〈0.05）,48 h组IL-6、MMP-9及IL-8差异有统计学结果（P〈0.01）。12 h组DEX干预后W/D差异有统计学意义（P〈0.05）。DEX干预组W/D24 h组和48 h均高于CLP组。结论脓毒症早期小剂量使用地塞米松可以有效的改善脓毒症的预后。地塞米松通过抑制炎症因子改善脓毒症预后,地塞米松对于脓毒症晚期炎症因子水平MMP-9及IL-8的调控作用可能较TNF-α等早期炎症因子更为重要。

Low-dose dexamethasone on MMP-9 and other inflammatory cytokines in septic rats

Objective To investigate dexamethasone influence on matrix metalloproteinase 9（MMP-9） and tumor necrosis factor-alpha（TNF-alpha）,interleukin-6（IL-6）,interleukin-8（IL-8） levels and survival rate of rats by es tablishment of a rat cecal ligation and puncture（CLP） model.Methods 78 SD rats were completely randomly divided into CLP-operated group,dexamethasone（DEX） by 0.1mg/mL treatment group（DEX）,meanwile the sham-operated group（SHAM） was established.DEX treatment group in the corresponding dose of dexamethasone given immediately after surgery.The animals were drawn into a mold at each time point to detect the survival rate,lung wet and dry weight ratio,MMP-9 and TNF-α,IL-6,IL-8 serum levels.Results The survival rate of rats with DEX was improved,but there was no statistical significance（P 0.05）.All groups of inflammatory mediators decreased.The 24 h groupIL-6 difference was statistically significant（P 0.05）,the 48 h group IL-6,MMP-9 and IL-8 were significantly different（P 0.01）.The 12 h group of DEX W/D the difference was statistically significant（P 0.05） and DEX group W/D 24 h of group and 48 h were higher than the CLP group.Conclusion Small doses dexamethasone in the early stage of sepsis can effectively improve the prognosis of sepsis.Dexamethasone can improve the prognosis of sepsis,by inhibiting inflammatory factors,dexamethasone regulation of MMP-9 and IL-8 levels of inflammatory factors for late sepsis compared with TNF-α early inflammatory factors may be more important.