关键词: 关键词 , 多器官功能障碍综合征, 血液透析滤过; , 内毒素；内毒素受体；高迁移率族蛋白1

Abstract:

Abstract  Objective： To observe the changes of endotoxin (LPS), its receptor CD14 and high mobility group-1 protein (HMGB1) in dogs with multiple organ dysfuncition syndrome (MODS) treated with continuous veno-venous haemodiafiltration (CVVHDF). Methodology：Eighteen male Beagle dogs were randomly divided into normal control group (n=6), MODS group (n=6) and HVH F group (n=6). Hemorrhagic shock plus resuscitation and endotoxemia (two-hit) method was used to establish the dog MODS model. CVVHDF was performed about 24 hours after LPS injection in MODS dogs of CVVHDF group. Plasma LPS, CD14 and HMGB-1 were determined before operation(T1), before LPS injection (T2) and 0h(T3), 3h(T4), 6h(T5), 9h(T6), 12h(T7), 18h(T8) and 24h(T9) after LPS injected. Protein express levels of CD14 and HMGB-1 in main organ tissues were detected by fluorescent detection of Western blot. Pathological changes of main organ tissues were observed under the light microscopy.  Results:  Compared with the MODS group, plasma levels of LPS, CD14 and HMGB-1 were significantly decreased in the CVVHDF group at T6-9 (P＜0.01). In CVVHDF group, protein express levels of CD14 and HMGB-1 in main organ tissues were decreased. The CD14 protein express levels of liver and brain in CVVHDF groups were significantly lower than that in MODS group (P＜0.05). The HMGB-1 protein express levels of lung, kidney and brain in CVVHDF groups were significantly lower than that in MODS group (P＜0.05). Pathological changes of major organs were improved in the CVVHDF group, as compared with animals in the MODS group.  Conclusion: Excessive inflammatory response may be the essential pathogenesis of MODS. CVVHDF can cut down the peak value of inflammatory cytokines including LPS, CD14 and HMGB-1, down-regulate protein express levels of CD14 and HMGB-1 in main organ tissues, which can prevent and treat MODS.

Key words: Key words , multiple organ dysfuncition syndrome, hemodiafiltration, LPS；CD14；HMGB-1