核因子-κB表达在多脏器功能障碍综合征发病机制及预后评估中作用的研究

发布时间：2018-07-09 15:54

本文选题：多脏器功能障碍综合征 + 核因子-κB　；参考：《天津医科大学》2006年硕士论文

【摘要】：目的:(1)比较并分析多脏器功能障碍综合征(MODS)存活组、死亡组患者及正常对照者外周血单核细胞(PBMC)中核因子-κB(NF-κB)mRNA、核因子-κB抑制性因子(IκBα)mRNA的表达和血清中肿瘤坏死因子(TNF-α)的浓度及其变化规律;(2)探讨NF-κB和TNF-α在MODS发病机制中的作用及其与MODS严重程度和预后的关系;(3)为早期防治多脏器功能障碍综合征提供理论依据。方法:收集MODS患者30例作为试验对象,其中多发性创伤11例,病理产科8例,重度感染4例,大手术后4例,心肺复苏后3例。患者平均年龄58岁(29岁～78岁),其中男20例,女10例。根据患者预后情况分为存活组和死亡组。存活组17例,平均年龄57岁(29岁～75岁),其中男11例,女6例;死亡组13例,平均年龄59岁(26岁～78岁),其中男9例,女4例。采用患者入ICU后第1个24小时内的最差参数作为评分用变量值,进行急性生理与慢性健康状况Ⅲ(APACHEⅢ)评分。同时随机抽取10例健康体检者作为正常对照组,平均年龄47岁(25岁～65岁),其中男6例,女4例。抽取MODS患者入ICU当天及正常对照者外周静脉血10mL,其中8mL置于加有肝素的玻璃离心尖管中,采用密度梯度离心法分离PBMC,并提取细胞中总RNA,应用逆转录-聚合酶链式反应法(PCR)检测PBMC中NF-κB、IκBαmRNA的表达。另外2mL置于灭菌无抗凝剂的塑料管中,室温凝固后离心,收集血清置于灭菌的硅化离心管中,-20℃冻存。应用放射免疫法(RIA)对血清标本进行TNF-α浓度测定。结果:(1)存活组患者PBMC中NF-κB mRNA相对表达量为1.247±0.512,IκBαmRNA相对表达量为1.372±0.743,血清中TNF-α浓度为1.578±0.179ng/ml,APACHEⅢ评分为48.125±12.699;死亡组患者PBMC中NF-κB mRNA相对表达量为1.179±0.508,IκBαmRNA相对表达量为0.875±0.451,血清中TNF-α浓度为1.775±0.476ng/ml,APACHEⅢ评分为93.250±16.611;正常对照组患者PBMC中NF-κB mRNA相对表达量为0.738±0.238,IκBαmRNA相对表达量为
[Abstract]:Objective: (1) to compare and analyze the expression of nuclear factor kappa B (NF- kappa B) mRNA, nuclear factor kappa B inhibitory factor (I kappa B) mRNA and the concentration of tumor necrosis factor (TNF- alpha) in serum and the regularity of its change in the peripheral blood mononuclear cells (PBMC) of the peripheral blood mononuclear cells (MODS) in the death group and the normal controls. (2) to discuss the NF- kappa and the alpha and alpha. Its role in the pathogenesis of MODS and its relationship with MODS severity and prognosis; (3) provide a theoretical basis for early prevention and treatment of multiple organ dysfunction syndrome.
Methods: 30 patients with MODS were collected as subjects, including 11 cases of multiple trauma, 8 cases of Obstetrics and Gynecology, 4 cases of severe infection, 4 cases after large operation and 3 cases after cardiopulmonary resuscitation. The average age of the patients was 58 years (29 to 78 years), including 20 men and 10 cases. The survival group was divided into survival group and death group. The average age was 57 years (29 years old). To 75 years old), among them, there were 11 males and 6 females, and 13 cases in the death group, with an average age of 59 years (26 years to 78 years), including 9 men and 4 women. The worst parameters in first 24 hours after ICU were used as the values of the score, and the acute physiological and chronic health status III (APACHE III) scores were evaluated. Meanwhile, 10 healthy persons were randomly selected as normal controls. The average age of 47 years (25 years to 65 years old), of which 6 men and 4 women, was selected from MODS patients on the same day and normal controls in peripheral venous blood 10mL, and 8mL was placed in the glass centrifuge tube with heparin, PBMC was separated by density gradient centrifugation, and the total RNA in the cells was extracted. Reverse transcription polymerase chain reaction (PCR) was used to detect N in PBMC. The expression of F- kappa B, I kappa B alpha mRNA, and 2mL in a sterilized plastic tube with no anticoagulant, centrifuged at room temperature, collected in a sterilized centrifuge tube, and stored at -20 centigrade. The concentration of TNF- alpha was measured by radioimmunoassay (RIA).
Results: (1) the relative expression of NF- kappa B mRNA in the PBMC of the survival group was 1.247 + 0.512, the relative expression of I kappa B alpha mRNA was 1.372 + 0.743, the concentration of TNF- a in the serum was 1.578 + 0.179ng/ml, and the APACHE III score was 48.125 + 12.699, and the relative expression of NF- kappa was 1.179 + 0.508, and the relative expression was 0.875 + 0.451 in the death group. The concentration of TNF- alpha was 1.775 + 0.476ng/ml, and the score of APACHE III was 93.250 + 16.611. The relative expression of NF- kappa B mRNA in the normal control group was 0.738 + 0.238, and the relative expression of I kappa B alpha mRNA was in the normal control group.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2006
【分类号】：R363;R449

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