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目的：探讨创伤休克对内毒素移位的影响及其与ＴＮＦ、ＩＬ－６产生的关系。方法：选用家兔１６只，随机分为创伤合并失血性休克（Ⅰ组）和单纯失血性休克组（Ⅱ组），采用鲎试验基质显色法，ＥＬＩＳＡ和细胞生物测定法分别测定血浆内毒素、ＴＮＦ和ＩＬ－６水平。结果：休克１．５小时，Ⅰ组血浆内毒素水平即明显高于伤前，至复苏后０．５小时达峰值，复苏后１小时仍明显高于伤前。休克后Ⅰ组血浆内毒素水平明显高于Ⅱ组；休克及复苏后，血浆ＴＮＦ、ＩＬ－６水平也先后显著升高，其中ＴＮＦ升高较早，Ⅰ组血浆细胞因子水平明显高于Ⅱ组；相关分析表明，创伤休克后血浆ＴＮＦ、ＩＬ－６均值分别与血浆内毒素均值呈显著正相关。结论：创伤休克可导致明显的内毒素血症及ＴＮＦ、ＩＬ－６等细胞因子过量产生，且较单纯休克时明显，创伤后细胞因子产生与内毒素移位有一定的内在联系。
Objective: To investigate the effect of traumatic shock on endotoxin translocation and its relationship with the production of TNF and IL-6. Methods: Twenty-six rabbits were randomly divided into two groups: traumatic hemorrhagic shock (group Ⅰ) and hemorrhagic shock group (group Ⅱ). The levels of endotoxin in plasma were determined by ELISA and cell bioassay. , TNF and IL-6 levels. Results: At 1.5 hours after shock, the level of plasma endotoxin in group Ⅰ was significantly higher than that before injury and reached the peak 0.5 hours after resuscitation. The level of plasma endotoxin in group Ⅰ was still significantly higher than that before injury one hour after resuscitation. After shock, plasma endotoxin level in group Ⅰ was significantly higher than that in group Ⅱ. After shock and resuscitation, the levels of TNF and IL-6 in plasma were significantly higher than those in group Ⅱ, and the levels of TNF in plasma were higher in group Ⅰ than those in group Ⅱ ; Correlation analysis showed that after traumatic shock, the mean values of plasma TNF and IL-6 were significantly and positively correlated with the mean plasma endotoxin. CONCLUSION: Traumatic shock can lead to obvious endotoxemia and overproduction of TNF, IL-6 and other cytokines. Compared with shock alone, traumatic shock may have some intrinsic relationship between trauma cytokine production and endotoxin translocation.