TNFα、NO在烧伤复合内毒素血症早期肾损害中的作用及其意义

目的 探讨肿瘤坏死因子α(TNFα)、一氧化氮(NO)在烧伤合并内毒素血症早期肾脏损害中的作用及其意义。方法 以大鼠体表烧伤Ⅲ度20％TBSA合并小剂量内毒素(1mg／kg体重)腹腔注射造成多脏器损害模型，按设计分组并在致伤后不同时相点进行肾脏病理形态学观察、TNFα和NO血清浓度测定、TNFα mRNA原位杂交和iNOS免疫组化染色。结果 烧伤后注射内毒素组诱导型一氧化氮合酶(iNOS)的表达和NO的合成以及TNFα mRNA的表达和TNFα的血浆水平均显高于和早于单纯烧伤组和单纯注射内毒素组。结论 烧伤合并内毒素血症时肾组织中NO和TNFα的水平显升高，两的升高可能是导致肾脏损害和引起肾脏血流动力学改变的重要因素之一。

The significance and the role of TNFalpha and NO in the early renal damage in burned rats complicated with endotoxemia]

OBJECTIVE: To explore the role and the significance of TNFalpha and NO in the early renal damage in burned rats complicated with endotoxemia. METHODS: The rats inflicted with 20% TBSA III degree burn and injected intraperitoneally with endotoxin (1 mg/kg) were employed as the model of MOD. The renal pathomorphology was observed at 0.5, 1, 3, 6, 12, 24, 48, 72 postburn hours. Concomitantly, the changes of renal and serum TNFalpha and NO were investigated and in situ hybridization for TNFalpha mRNA and immunohistochemical staining for iNOS were performed. RESULT: The expressions of renal iNOS and TNFalpha mRNA, the NO synthesis and the serum levels of NO and TNFalpha in BCEG (burns complicated with endotoxin group) were obviously higher and appeared earlier than those in SBG (simple burns group) and SEG(simple endotoxin group). CONCLUSION: The renal TNFalpha and NO increased significantly in rats subjected to burn complicated with endotoxemia, which might be important factors causing renal damage and the alterations in renal hemodynamics.