Effects Of Continuous Venovenous Hemodiafiltration On Plasma LPS、IL-1β、IL-4HMGB-1in Multiple Organ Dysfunction Syndrome Dogs

Objective:To investigate the effects of continuous venovenous hemodiafiltration (CVVHDF) on plasma LPS, IL-1β, IL-4, HMGB-1in multiple organ dysfunction syndrome (MODS) dogs, to explore the therapeutic mechnism of CVVHDF. Methods: Dogs were subjected to hemorrhagic shock plus resuscitation and endotoxemia to establish MODS model, then they were randomly divided into2groups:CVVHDF group (n=6) and MODS group (n=6). After endotoxin injection completed, the CVVHDF group received CVVHDF treatment for24h; MODS group did not receive CVVHDF treatment. The LPS, IL-1β, IL-4, HMGB-1levels in plasma and ultrafiltrate were measured at different time points(before operation, before intravenous infusion of endotoxin,0h,3h,6h,9h,12h,18h,24h after intravenous infusion completion of endotoxin),then the sieving coefficient (SC) was calculated. Results:Compared with MODS group, the LPS,IL-1β, IL-4, HMGB-1levels in plasma were significantly decreased in the CVVHDF group at9h,12h,18h,24(P<0.05).Some concentration of IL-1β,IL-4and HMGB-1was detected in the ultrafiltrate,the SC for IL-1β, IL-4and HMGB-1was0.60±0.12,0.83±0.11,0.70±0.09respectively, and LPS could not be detected in the ultrafiltrate, its SC was0. After treatment, the damage level of lung and renal had been significantly reduced in CVVHDF group. Conclusions:CVVHDF can effectively reduce the levels of pro-inflammatory mediator and anti-inflammatory cytokine related to MODS, cut off the vicious circle of cytokine network and reduce the damage level of organism in the treatment of MODS.