预防性应用 PA －MSHA 对严重脓毒症中性粒细胞移行的影响

摘要

目的通过观察铜绿假单胞菌－甘露糖敏感血凝素（PA－MSHA）对严重脓毒症大鼠中性粒细胞体外移行的影响，探讨严重脓毒症发病机制及PA－MSHA对严重脓毒症的作用。方法大鼠随机分为对照组（C组）、严重脓毒症组（SS组）、PA－MSHA预处理组（PA组）和PA－MSHA预处理严重脓毒症组（PA－SS组）。严重脓毒症动物模型通过人粪便悬液腹腔注射制作。PA－MSHA预处理方案为连续7d0．3mLPA－MSHA皮下注射。观察大鼠一般情况，48h生存情况，大体解剖观察，中性粒细胞体外趋化数，细胞因子IL－6、iNOS、IL－10水平。结果PA－SS组在一般情况、48h生存情况、大体解剖观察上均优于SS组，细胞因子水平也较SS组下降。SS组及PA－SS组与C组和PA组比较，中性粒细胞体外趋化数量显著下降（P＜0．01）。C组与PA组、SS组与PA－SS组中性粒细胞体外趋化细胞数比较差异无统计学意义（P＞0．05）。结论严重脓毒症时中性粒细胞体外移行能力发生严重障碍，连续7d0．3mLPA－MSHA预处理无法改善严重脓毒症中性粒细胞体外移行能力，但可通过下调炎症因子水平，减缓严重脓毒症病情恶化，延长生存时间，为临床救治争取宝贵时间。%Objective To investigate the mechanisms of severe sepsis and the effects of pseudomonas aeruginosa-mannose sensitive haemagglutinin(PA-MSHA)in severe sepsis by analyzing neutrophil migration.Methods Four groups were randomized: the control group ( C group ) , severe sepsis group( SS group) , PA-MSHA group( PA group) , PA-MSHA+severe sepsis group ( PA-SS group) .Severe sepsis rat model was established by human stool suspension injection, equal normal saline were given to the C grou,p 0.3 mL PA-MSHA were injected subcutaneously in PA group and PA-SS group for7 days.General condition, 48 hours survival situation, gross anatomy, the number of neutrophil migration in vitro and cytokine IL -6, iNOS andIL-10 of the rats were observed.Result s The general condition, 48 hours survival situation and gross anatomy of the PA -SS group rats were better than SS group.The levels of serum cytokines were all descended in PA-SS group than those in SS group.Compared with C group and PA group, the number of neutrophil migration in vitro of SS group and PA -SS group were significantly decreased ( P <0.01 ) .There was no statistically significant difference in the number of neutrophil migration of C group compared with PA group, and SS group compared with PA-SS group (P>0.05).Conclusion 0.3 mL PA-MSHA preconditioning for 7 days could not enhance the function of neutrophil migration in vitro in severe sepsis, but it could slow severe sepsis'deterioration, prolong the survival time and strive for the precious time for clinical treatment in part by down regulating the level of cytokines in serum.