连续性血液净化对内皮细胞组织因子活性的影响及相关因素分析

王建文; 彭佑铭; 陈星; 刘伏友; 张浩

PDF(496 KB)

中国血液净化 ›› 2007, Vol. 6 ›› Issue (2) : 81-84.

基础研究

连续性血液净化对内皮细胞组织因子活性的影响及相关因素分析

王建文1 彭佑铭2 陈星2 刘伏友2 张浩1

作者信息 +

文章历史 +

摘要

目的　探讨连续性血液净化(CBP)对体外培养内皮细胞组织因子(TF)活性的影响及其相关因素。方法　采用脐静脉内皮细胞株培养、一期凝固法检测组织因子活性；酶联免疫吸附法测定血清TNF-α，IL-1β浓度。结果连续性血液净化能有效清除多器官功能障碍(MODS)患者血清TNF-α，IL-1β等细胞因子；体外培养内皮细胞经MODS患者血清刺激后组织因子活性较空白对照组明显升高(P＜0.05)。经CBP治疗后，患者血清对内皮细胞TF活性的影响呈下降趋势，与治疗过程中血清TNF-α，IL-1β变化趋势一致，呈正相关(TNF-α：r=0.655,P＜0.05；IL-1β：r=0.630,P＜0.05)。肿瘤坏死因子呈剂量依赖性增加内皮细胞组织因子活性(r =0.899, P＜0.01)，而肝素对TF活性无明显影响。结论连续性血液净化可以部分改善MODS患者内皮细胞功能，降低内皮细胞组织因子活性，其机制可能通过清除TNF-α，IL-1β等细胞因子而实现。

Abstract

Objective To explore effects of continuous blood purification (CBP) on endothelial cell tissue factor(CTF) activity and correlation factors.Methods Human umbilical vein endothelial cells(HUVEC) were selected to study, one-stage clotting assays was used to measure tissue factor activity.Serum levels of TNF-αand IL-1βwere detected by ELISA.Results CBP could eliminate cytokines such as TNF-αand IL-1βof patients with multiple organ dysfunction syndrome (MODS).Tissue factor activity was increased compared with basal group when endothelial cell was interfered by predialysis serum (P＜0.05).And endothelid cell TF activity was decreased after being cultured with patients serum which had positive correlation with the changes of TNF-αand IL-1β during treatiment (TNF-α：r=0.655,P＜0.05；IL-1β：r=0.630,P＜0.05).TNF-α increased TF activity in a dose-dependent manner(r=0.899,P＜0.01) but heparin did not influence TF activity. Conclusion Continuous blood purification can improve endothelial cell’s function of MODS patients in part and reduce TF activity. The effect was implemented by eliminating cytokines such as TNF-αand IL-1β.