本文選題：多臟器功能障礙綜合征 + 核因子-κB�。� 參考：《天津醫(yī)科大學(xué)》2006年碩士論文

【摘要】：目的:(1)比較并分析多臟器功能障礙綜合征(MODS)存活組、死亡組患者及正常對(duì)照者外周血單核細(xì)胞(PBMC)中核因子-κB(NF-κB)mRNA、核因子-κB抑制性因子(IκBα)mRNA的表達(dá)和血清中腫瘤壞死因子(TNF-α)的濃度及其變化規(guī)律;(2)探討NF-κB和TNF-α在MODS發(fā)病機(jī)制中的作用及其與MODS嚴(yán)重程度和預(yù)后的關(guān)系;(3)為早期防治多臟器功能障礙綜合征提供理論依據(jù)。 方法:收集MODS患者30例作為試驗(yàn)對(duì)象,其中多發(fā)性創(chuàng)傷11例,病理產(chǎn)科8例,重度感染4例,大手術(shù)后4例,心肺復(fù)蘇后3例�；颊咂骄挲g58歲(29歲～78歲),其中男20例,女10例。根據(jù)患者預(yù)后情況分為存活組和死亡組。存活組17例,平均年齡57歲(29歲～75歲),其中男11例,女6例;死亡組13例,平均年齡59歲(26歲～78歲),其中男9例,女4例。采用患者入ICU后第1個(gè)24小時(shí)內(nèi)的最差參數(shù)作為評(píng)分用變量值,進(jìn)行急性生理與慢性健康狀況Ⅲ(APACHEⅢ)評(píng)分。同時(shí)隨機(jī)抽取10例健康體檢者作為正常對(duì)照組,平均年齡47歲(25歲～65歲),其中男6例,女4例。抽取MODS患者入ICU當(dāng)天及正常對(duì)照者外周靜脈血10mL,其中8mL置于加有肝素的玻璃離心尖管中,采用密度梯度離心法分離PBMC,并提取細(xì)胞中總RNA,應(yīng)用逆轉(zhuǎn)錄-聚合酶鏈?zhǔn)椒磻?yīng)法(PCR)檢測(cè)PBMC中NF-κB、IκBαmRNA的表達(dá)。另外2mL置于滅菌無抗凝劑的塑料管中,室溫凝固后離心,收集血清置于滅菌的硅化離心管中,-20℃凍存。應(yīng)用放射免疫法(RIA)對(duì)血清標(biāo)本進(jìn)行TNF-α濃度測(cè)定。 結(jié)果:(1)存活組患者PBMC中NF-κB mRNA相對(duì)表達(dá)量為1.247±0.512,IκBαmRNA相對(duì)表達(dá)量為1.372±0.743,血清中TNF-α濃度為1.578±0.179ng/ml,APACHEⅢ評(píng)分為48.125±12.699;死亡組患者PBMC中NF-κB mRNA相對(duì)表達(dá)量為1.179±0.508,IκBαmRNA相對(duì)表達(dá)量為0.875±0.451,血清中TNF-α濃度為1.775±0.476ng/ml,APACHEⅢ評(píng)分為93.250±16.611;正常對(duì)照組患者PBMC中NF-κB mRNA相對(duì)表達(dá)量為0.738±0.238,IκBαmRNA相對(duì)表達(dá)量為
[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.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2006
【分類號(hào)】：R363;R449

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本文編號(hào)：2109872