抗R595单克隆抗体对腹腔感染伴多器官功能障碍时代谢的影响

观察抗内毒素核心糖脂单克隆抗体对腹腔感染（ＩＡＩ）伴多器官功能障碍（ＭＯＤ）时代谢的影响．将２０只健康成熟期新西兰白兔按照盲肠结扎加穿孔的方法（ＣＬＰ）诱发ＩＡＩ伴ＭＯＤ，手术后随机分成２组，每组１０只．抗内毒素核心糖脂抗体组在ＣＬＰ后０．５ｈ静脉注射抗Ｒ５９５单抗１０ｍｇ／ｋｇ，对照组按同样方法和剂量给予非特异性单株免疫球蛋白（ＳＰ２）．动态测定了血浆内毒素、血清细胞因子（ＴＮＦ、ＩＬ－６）、激素（皮质醇、胰岛素、胰高血糖素）、生化（葡萄糖、胆固醇、甘油三酯、白蛋白）和尿中尿素氮、肌酐、３－甲基组氨酸排出的变化，观察时间１周，并记录动物死亡情况．与对照组比较，抗内毒素核心糖脂抗体组血浆内毒素、血清ＴＮＦ和ＩＬ－６水平均显著降低，血清皮质醇浓度减低，胰岛素和胰高血糖素浓度无显著变化，血中葡萄糖、胆固醇、甘油三酯和白蛋白改变明显改善，尿中尿素氮、肌酐和３－甲基组氨酸排出量显著减少，生存率显著提高．抗内毒素核心糖脂抗体具有防治ＩＡＩ伴ＭＯＤ时代谢紊乱的代谢调理作用

THE METABOLIC INTERVENTION OF A MONOCLONAL ANTIBODY AGAINST ROUGH MUTANT OF S. MINNESOTA (R595) IN INTRA ABDOMINAL INFECTION COMPLICATED BY MULTIPLE ORGAN DYSFUNCTION

To observe the effect of a monoclonal antibody against the rough mutant of S. minnesota (R595) on the metabolism of intra abdominal infection (IAI) complicated by multiple organ dysfunction (MOD) in rabbits. Twenty white New Zealand rabbits were divided into two groups after having received laparotomy and cecal ligation plus puncture (CLP) which induced IAI and MOD. One group (R) was given with a monoclonal antibody directed to the rough mutant of S. monnesota (R595) with the dose of 10mg/kg at 0.5h after CLP while another group (C) was given with a single nonspecific immunoglobulin (SP 2) as control. Compared with C group, R group showed that the blood levels of endotoxin, tumor necrosis factor, interleukin 6 and cortisol were significantly decreased, the blood concentrations of insulin and glucagon did not change significantly, the abnormal changes in glucose, cholesterol, triglyceride and ablumin were significantly attenuated, the daily excretions of urea nitrogen, creatinine and 3 methylhistidine in the urine were significantly decreased, and the survival rate was significantly raised. The monoclonal antibody against exdotoxin has the role of metabolic intervention in IAI and MOD.