【摘要】 目的 探讨多器官功能障碍综合征(MODS)患者外周血单个核细胞(PBMCs)中过氧化物酶体增殖物激活受体γ(PPARγ)与核转录因子-κB(NF-κB)的表达和关系。方法 选择我院ICU和急诊科MODS患者60例,分为3组,每组20例,MODS 1组(舭ACH也Ⅱ评分0~10分),MODS 2组(APACHEⅡ评分11~20分),MODS 3组(APACHEⅡ评分>20分)及正常对照组(20例健康对照者)为研究对象。确诊后分别于1、3、6 d取静脉血,采用逆转录聚合酶链反应(RT-PCR)检测PPARγ、NF-κB的表达与同期正常对照组进行比较分析。结果 ①正常组PBMCs中PPARγ、NF-κBp65表达量均较少。与正常组比较,MODS 1组PPARγ、NF-κBp65表达均明显增高,随治疗时间推移,PPARγ表达明显增高(P<0.05);而NF-κBp65表达则明显降低(P<0.05)。MODS 2组、MODS 3组PPARγ表达低于正常对照组,随着治疗时间增加,PPARγ明显下降(P<0.05);NF-κBp65表达高于正常对照组,随着治疗时闯增加,NF-κBp65明显升高(P<0.05)。②相关结果 分析表明,PBMCs中PPARγ与NF-κBp65表达在MODS 1组、MODS 2组、MODS 3组星负相关性(MODS 1组:r=-0.726,P<0.01;MODS 2组:r=-0.736,P<0.01;MODS 3组:r=-0.721,P<0.01),在正常对照组无明显相关性(r=0.183,P>0.05)。结论 PPARγ可能通过抑制NF-κB的表达对MODS患者起到保护作用,可作为MODS病情判断重要指标和治疗潜在靶点。更多还原

【Abstract】 Objective To study the expression and relationship of nuclear factor- kappa B(NF- kB) and peroxisome proliferators activated receptory(PPARγ) in peripheral blood monouclear cells(PBMCs) of multiple organ dysfunction syndrome(MODS) patients.Methods In the emergency department and intensive care unit(ICU) of our hospital,60 MODS patients were divided into three groups with 20 cases in each group.They were MODS1 group(APACHE Ⅱ score 0 ~ 10 points),MODS2 groups(APACHE Ⅱ score 11 ~ 20 points),MODS 3 groups(APACHE Ⅱ score > 20 points) and control groups of 20 healthy subjects.Venous blood were sampled 1,3,6 d after diagnosis of MODS.Reverse transcriptase- polymerase chain reaction(RT- PCR) was used to detect the expression of PPAR-y,NF- κB in PBMCs.The expression of PPARγ,NF- κB in the same period were compared between the MODS groups and the healthy control group.Results ①The expression of NF- κBp65 and PPARγ was low in vehicle control group.In MODS 1 group the expression of PPARγ and NF- κBp65was higher than that in vehicle control group;during the treatment period,PPARγ was significantly increased(P < 0.05),but the expression of NF-κBp65 was was significantly lowered(P < 0.05).PPAR7 expression in MODS 2 group,MODS 3 group was lower than that in vehicle control group,and its expression was progressively decreased during the treatment(P < 0.05);in contrast,expression of NF-κBp65 in MODS 2 and MODS 3 group was higher than that in vehicle control group,and its level was progressively increased during the treatment(P < 0.05).The study revealed a significant negative correlation between NF- κBp65 and PPARy in MODS 1 group,MODS 2 group and MODS 3 group(MODS1 group:r=-0.726,P<0.01;MODS 2 group:r=-0.736,P<0.01;MODS 3 group:r =-0.721,P < 0.01).There was no significant correlation in vehicle control group(r =-0.183,P > 0.05).Conclusion PPARγ may protect the MODS patients by repressing the expression of NF-kB,therefore it can be used as an important indicator and potential target to determine the condition and treatment of MODS.更多还原