持续性血液净化加灌流对腹部外伤海水浸泡犬血浆炎性细胞因子的影响

目的探讨持续性血液净化（CRRT）加灌流对腹部外伤合并海水浸泡实验犬血浆内毒素（ETX）、白介素6（IL-6）、肿瘤坏死因子-α（TNF-α）水平的影响。方法16只实验犬致伤后随机分为治疗组和对照组。对照组伤后给予生理盐水持续静脉滴注维持，治疗组给予持续性血液净化加用树脂罐灌流。分别于致伤前及伤后3、6、9、12、18h取血测定血浆ETX、IL-6、TNF-α平。结果对照组和治疗组在伤后6hETX开始明显升高，IL-6和TNF-α在伤后12h升高显著。但治疗组在伤后ETX、IL-6和TNF—α水平明显低于对照组。对照组在12h以后血浆肌酐、尿素氮水平升高明显．同炎性因子的变化相一致，而治疗组则无明显变化。对照组动物死亡率明显高于治疗组。结论持续性血液净化加灌流技术可以明显减轻实验犬血浆炎性因子水平，有利于稳定内环境。

The effects of combined CRRT-hemoperfusion on inflammatory cytokines in the abdominal injury of dogs following seawater immersion

Objective To study the effects of combined CRRT-hemoperfusion on ETX, IL-6 and TNF-α in the abdominal injury of dogs following seawater immersion. Methods The 16 healthy dogs were divided randomly into two groups. Animals in control groups accepted Sodium Chloride injection only, Animals in treated groupa accepted Sodium Chloride injection and combined CRRT-Hemoperfusion. Blood samples were taken before the trauma （0 hour） and at 3,6,9,12,18 hours after the trauma and seawater immersion for both groups. ETX, IL-6 and TNF-α were detected. Results ETX, IL-6 and TNF-α were higher in both groups, but the level of ETX, IL-6 and TNF-α in treated groups were significantly lower than that in control groups（P〈0.05）. The levels of BUN and Cr were higher in control groups at 12 hours, the changes were positively correlated with the changes of ETX, IL-6 and TNF-α. The death rate in control groups was higher than that in treated groups. Conclusion Combined CRRT- hemoperfusion could decrease the level of related inflammatory cytokines in the abdominal injury of dogs following seawater immersion.