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目的研究细胞黏附分子在高容量血液滤过(HVHF)干预多器官功能障碍(MODS)猪模型过程中的表达变化情况。方法18头实验动物被随机分为2组：模型组(M组)实施失血性休克+内毒素注射“二次打击”,而治疗组(HF组)在二次打击后接受HVHF干预。检测两组中性粒细胞(PMN)表面CD11b、L-选择素(selectin)的表达和血浆中可溶性E选择素(sE-selectin)、可溶性细胞间黏附分子(sICAM-1)的浓度。结果HVHF治疗开始后,HF组CD11b表达出现下降,在各个时间点与M组比较,差异有统计学意义P＜0.01；治疗组中L-selectin的表达在治疗后24、48h处表达高于M组的表达(P＜0.05)。治疗开始后sE-selectin浓度就出现明显下降。治疗后24h与M组比较差异有统计学意义(P＜0.01),到治疗后48h(P＜0.05)和72h(P＜0.01)已经高于M组水平；治疗后24h,HF组中sICAM-1水平低于M组(P＜0.05),此后维持于较高水平,至治疗后72 h高于M组(P＜0.01)。结论HVHF可以间接、双向调节MODS发生过程中细胞黏附分子的表达水平以及PMN、内皮细胞的活化状态。
Objective To investigate the expression changes of cell adhesion molecules during the process of high-volume hemofiltration (HVHF) intervention in multiple organ dysfunction (MODS) pig model. Methods Twenty - eight experimental animals were randomly divided into two groups: model group (M group) received hemorrhagic shock + endotoxin injection “second strike”, while the treatment group (HF group) received HVHF after the second strike. The expression of CD11b, selectin and sE-selectin and soluble intercellular adhesion molecule (sICAM-1) in the plasma of two groups of neutrophils (PMN) were detected. Results The expression of CD11b in HF group decreased after HVHF treatment. The difference was statistically significant at each time point compared with M group (P <0.01). The expression of L-selectin in HF group was higher than that of M at 24 and 48h after treatment Group (P <0.05). After treatment began sE-selectin concentration decreased significantly. The levels of sICAM-1 in HF group were significantly higher than those in M group at 24 h after treatment (P <0.01), and at 48 h after treatment (P < 1 level was lower than M group (P <0.05), then maintained at a high level, higher than M group 72h after treatment (P <0.01). Conclusion HVHF can indirectly and bidirectionally regulate the expression of cell adhesion molecules and the activation status of PMN and endothelial cells during the development of MODS.