血小板线粒体功能在脓毒症病情监测的意义

来源 :中国呼吸与危重监护杂志 | 被引量 : 0次 | 上传用户:breeze_86
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目的通过检测外周血小板线粒体的通透性转变孔、跨膜电位和三磷酸腺苷(ATP)水平,探讨血小板线粒体功能与脓毒症严重程度的关系。方法取雄性SD大鼠40只,按照随机数字表法分为脓毒症模型组(A、B、C组)和假手术组(D组)。模型组予以盲肠结扎穿孔术(CLP)处理,按照盲肠结扎长度占盲肠总长度的10%、30%、50%依次分为A、B、C组。24 h后收集外周血,检测外周血清肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)、IL-6等炎症因子水平,以及血小板线粒体通透性转变孔、跨膜电位和ATP水平的变化,采用One-way ANOVA检验法判断上述指标与脓毒症严重程度的关系。收集临床脓毒症病例29例并根据病情进行APACHEⅡ评分,收集外周血标本检测同期血小板线粒体功能,采用Spearman法分析其与APACHEⅡ评分的相关性。结果在动物模型中,随着CLP程度的加重,大鼠外周血小板线粒体钙黄绿素荧光减弱,跨膜电位显著下降,ATP合成减少,各组间差异有统计学意义(P<0.05)。在临床标本中,APACHEⅡ评分与血小板线粒体ATP水平呈负相关(r=-0.895,P<0.05)。结论外周血小板线粒体功能可作为脓毒症病情监测的有效指标。 Objective To investigate the relationship between platelet mitochondrial function and the severity of sepsis by detecting the permeability transition pore, transmembrane potential and ATP of peripheral platelet mitochondria. Methods Forty male Sprague Dawley rats were randomly divided into sepsis model group (A, B, C) and sham operation group (D) according to random number table. The model group was treated with cecal ligation and puncture (CLP). According to the length of caecum ligation, the total length of caecum was divided into A, B and C groups according to the total length of cecum of 10%, 30% and 50%. Peripheral blood was collected 24 hours later and the levels of inflammatory cytokines such as TNF-α, IL-1β and IL-6 in peripheral blood were detected. The mitochondrial permeability transition pore and transmembrane potential And ATP levels, using One-way ANOVA test to determine the relationship between the above indexes and the severity of sepsis. 29 cases of clinical sepsis were collected and APACHEⅡscore was collected according to the disease. Peripheral blood samples were collected to detect mitochondrial mitochondrial function during the same period. Spearman method was used to analyze the correlation with APACHEⅡscore. Results In the animal model, the mitochondrial calcein fluorescence decreased, the transmembrane potential decreased significantly and the ATP synthesis decreased with the severity of CLP. The difference between the two groups was statistically significant (P <0.05). In clinical samples, APACHE II score was negatively correlated with platelet mitochondrial ATP level (r = -0.895, P <0.05). Conclusion Peripheral platelet mitochondrial function can be used as an effective indicator of sepsis condition monitoring.
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