摘要:目的 研究环氧合酶2(cyclooxygenase-2,COX-2)在脓毒症大鼠肝组织炎症反应中的表达及其对免疫功能的影响.方法 选择质量相近的Wistar大鼠54只,分为假手术组(6只)、脓毒症组(24只)、NS-398干预组(24只).通过建立盲肠结扎穿孔脓毒症动物模型,用RT-PCR方法检测肝组织COX-2mRNA的表达,ELISA法检测血清IL-6、IL-10、TNF-α水平,流式细胞仪检测T淋巴细胞亚群CD4+、CD8+细胞的变化,同时观察肝脏病理变化.结果 (1)脓毒症组病理损伤重,NS-398干预组损伤减轻.(2)COX-2mRNA:假手术组呈低表达,脓毒症组、NS-398干预组升高,但NS-398干预组较脓毒症组明显偏低.(3)IL-6:脓毒症组较假手术组和NS-398干预组明显增高(F=125.582,134.712,54.760,121.441,P<0.05).(4)IL-10:NS-398干预组高于假手术组和脓毒症组(F=39.064,34.382,51.115,8.174,P<0.05).(5)TNF-α:脓毒症组、NS-398干预组增高,但两组比较差异无统计学意义(x2=5.600,6.162,7.136,7.200,P>0.05).(6)CD4+/CD8+比值:NS-398干预组高于脓毒症组(F=17.448,15.055,30.068,64.210,P<0.05).结论 COX-2在脓毒症中发挥重要作用,其作用途径可能是通过改变促炎、抗炎细胞因子之间以及CD4+、CD8+细胞之间的平衡,使机体免疫状态紊乱而实现的.%Objective To study the expression of cyclooxygenase-2(COX-2)in hepatic inflammatory reaction and the effects of COX-2 on immunologic function of rats with sepsis.Methods Fifty-four Wistar rats were divided into sham group(n=6),sepsis group(n=24),and NS-398 intervention group(n=24).All rats were subjected to cecal ligation and puncture or sham operation.The expression of COX-2 mRNA in rat hepatic tissue was determined by RT-PCR,serum levels of IL-6,IL-10 and TNF-α were detected by ELISA,and percentage changes of CD4+,CD8+ cells by flow eytometry.The pathological changes of liver were observed at the same time.Results (1)Severe pathologic injuries of liver were observed in sepsis group,while not in NS-398 intervention group.(2)The expression of COX-2 mRNA was up-regulated in sepsis group and NS-398 intervention group,and the expression value was higher in sepsis group than that in NS-398 intervention group.The expression of COX-2 mRNA was the lowest in sham group.(3)The level of IL-6 was higher in sepsis group than that in sham group and NS-398 intervention group(F=125.582,134.712,54.760,121.441,P<0.05).(4)The level of IL-10 was higher in NS-398 intervention group than that in sham group and sepsis group(F=39.064,34.382,51.115,8.174,P<0.05).(5)The levels of TNF-α in sepsis group and NS-398 intervention group were increased,and the difference between the 2 groups had no statistical significance(x2=5.600,6.162,7.136,7.200,P>0.05).(6)The ratio of CD4+to CD8+ was higher in NS-398 group than that in sepsis group(F=17.448,15.055,30.068,64.210,P<0.05).Conclusions COX-2 plays an important role in the development of sepsis by changing the dynamic equilibrium between pro-inflammatory and anti-inflammatory cytokine and that between CD4+and CD8+.