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目的 研究颈脊髓切断对内毒素休克大鼠全身炎症反应及预后的影响.方法 92只SD大鼠被随机分为正常对照组(n=8)、内毒素休克模型组(n=42)及内毒素休克+颈脊髓切断组(n=42),后两组各取10只大鼠于制模后观察48 h存活率,其余大鼠再按制模后3、6、12和48 h分为4个亚组,每亚组8只动物.切断大鼠C7脊髓制备颈脊髓切断动物模型;腹腔注射内毒素脂多糖(LPS)10 mg/kg造成动物内毒素休克.处死动物开胸取血,采用高效液相色谱法(HPLC)测定血浆中去甲肾上腺素(NE)含量,用双抗体夹心酶联免疫吸附法(ELISA)检测血浆中白细胞介素-10(IL-10)及IL-6的含量.结果 模型组血浆NE含量逐渐升高,而切断组逐渐下降.但均较对照组显著升高(P均＜0.05);自6 h起切断组显著低于模型组(P均＜0.05).模型组血浆IL-10含量于3 h和6 h时显著低于对照组(P均＜0.05),之后逐渐升高(P均＞0.05);切断组于各时间点显著高于模型组,且于12 h和48 h显著高于对照组(P均＜0.05).模型组各时间点血浆IL-6含量均高于对照组(P均＜0.05);切断组3、6和12 h显著低于模型组(P均＜0.05),且与对照组差异无统计学意义,而在48 h时较对照组显著升高(P＜0.05).切断组大鼠48 h存活率高于模型组(70%比20%).结论 颈脊髓切断可增加内毒素休克大鼠血浆中IL-10的含量,抑制IL-6生成,并能提高48 h存活率,对内毒素休克大鼠的全身炎症反应及预后具有改善的作用.“,”Objective To investigate the effects of cervical chordotomy on systemic inflammatory response and the outcome in rats with endotoxemia induced by lipopolysaccharide(LPS).Methods Ninety-two Sprague Dawley(SD)rats were randomly divided into three groups:normal control group (group I,n=8),endotoxemia group(group I n=42)and endotoxemia with cervical chordotomy (group Ⅱ,n=42).Endotoxemia was induced by intra-peritoneal injection of LPS 10 mg/kg.In group Ⅱ,“cervical chordotomy”was attained by transection of spinsl cord at C7 immediately before intra-peritoneal LPS administration.Ten rats of group Ⅱ and Ⅱ each were observed for 48-hour survival.The other rats were further divided into four subgroups of 8 animals each,according to the time when the animals were sacrificed.The animals were sacrificed at 3,6,12,and 48 hours after intra-peritoneal LPS injection.Heart blood samples were obtained for determination of plasma concentration of norepinephrine[NE,by high performance liquid chromatography(HPLC)] and plasma concentration of interleukin-10(IL-10)and IL-6 [by enzyme linked immunosorbent assay(ELISA)].Results Plasma NE concentration were significantly increased after intra-peritoneal LPS injection in group Ⅱ and Ⅱ as compared with group I and were significantly lower in group Ⅱ than in group Ⅱ starting from 6 hours after LPS(all P＜0.05).Plasma IL-10 concentration was significantly lower at 3 hours and 6 hours while plasma IL-6 concentration was significantly higher after LPS challenge in group Ⅱ than in group I at all time points(all P＜0.05).High transection of spinal cord significantly elevated plasma IL-10 level at 12 hours and 48 hours,lowered IL-6 release at 3,6,and 12 hours(all P＜0.05),and improved 48-hour survival(20%vs.70%)in group Ⅱ as compared with group Ⅱ.Conclusion Transection of spinal cord at C7 level can ameliorate the systemic inflammatory response induced by endotoxemia thus improving the outcome through elevation in IL-10 level,decreases in IL-6 release,and improves 48-hour survival.This might be attributable to loss of sympathetic nerve function.