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目的:观察应用抗肿瘤坏死因子-α(TNFα)单抗对重度肠缺血/再灌注损伤时动物血液动力学的影响及其机理。方法:大鼠肠系膜上动脉阻断75分钟后再灌注6小时,分别静脉给予抗TNFα单抗(防治组)或白蛋白(对照组)。结果:使用抗TNFα单抗可减轻缺皿/再灌注所致血压和心脏指数下降(P<0.01),每搏输出量维持于伤前范围。防治组72小时存活率(90%,9/10)显著高于对照组(20%,2/10)。抗TNFα单抗可有效中和循环中TNFα,并抑制心肌组织TNF mRNA的表达。结论:抗TNFα单抗可显著减轻肠缺血/再灌注后的心血管功能障碍,改善存活率。其作用机理与抑制心肌组织TNF mRNA的表达、中和循环TNF的释放密切相关。
Objective: To observe the effect and mechanism of anti-tumor necrosis factor-α (TNFα) monoclonal antibody on hemodynamics in severe intestine ischemia / reperfusion injury. Methods: After blocking the superior mesenteric artery in rats for 75 minutes and then for 6 hours, anti-TNFα monoclonal antibody (control group) or albumin (control group) were given intravenously. Results: The anti-TNFα mAb could reduce the blood pressure and heart index (P <0.01) caused by lack of dish / reperfusion, and the stroke volume maintained at pre-injury range. The 72-hour survival rate (90%, 9/10) in the control group was significantly higher than that in the control group (20%, 2/10). Anti-TNFα mAb can effectively neutralize circulating TNFα and inhibit the expression of TNF mRNA in myocardial tissue. Conclusion: Anti-TNFα monoclonal antibody can significantly reduce cardiovascular dysfunction after intestinal ischemia / reperfusion and improve survival rate. Its mechanism of action is closely related to the inhibition of the expression of TNF mRNA in myocardium and the release of TNF in the circulation.