The Analysis Between TNF-α In Blood And The Level Of Lipid Peroxidation In Pancreas In Multiple Organ Dysfunction Syndrome

Purpose:Multiple organ dysfunction syndrome was defined firstly by Tilney as"sequential system failure"about 30 years ago.Although the clinical treatments for patients have been constantly improving,the mortality is high.As a result MODS is still an acute and severe clinical disease and one of the main reasons contributing to the death of critical patients.Current studies have suggestted that"double-hit"hypothesis could be reasonable to its pathogenesis.When a body suffers from two hits,plenty of pre-inflammatory and anti-inflammatory mediums are produced.These would cause overwhelming inflammation reactions;then,the body can not sustain the homeostasis and would result in the presence of MODS and even death.Current studies of acute pancreatitis have been improving,but the etiology and mechanism of organ damage remain obscure.Therefor,this field becomes the focus of the clinicians.Besides the theory of trypsinogen activation and self-digestion,pancreatic damage caused by substantial releasing of cytokines and microcirculation disturbance has gradually become a hot topic.In this experiment.the pig model of MODS was established.The vital signs of animals were observed.At the same time cytokines,pancreatic pathology change and the level of lipid peroxidation were monitored and compared.Methods:In first part of the experiment,a pig model of MODS was successfully established according to the"double-hit"theory.In the first step 20 Pigs were anesthetic, then the mean arterial pressure was decreased to 55±5 mmHg and maintained for 2 hour. Secondly 60%of the blood loss and the double volume of equilibrium liquid were transfused into these animals for resuscitation.Thirdly after 24 hour,1.0mg/kg of endotoxin(Escherichia coli endotoxin O55B5,sigma company) was given continuously by intravenous infusion.During the study,the heart rate,respiratory rate and arterial blood pressure were supervised.At the same time,the specimens of blood were collected everyday for serum ALT,AST,Cr,BUN,blood routine examination and blood gas analysis.In the second part of the experiment,after endotoxin was infused 4 animals were randomly selected at 0 hour,24 hours,48 hours,72 hours and 96 hours,respectively. TNF-αin blood and MDA of pancreatic tissue were measured,meanwhile we made the pathological scores of pancreatic slices.At the end,the correlation was analysised.Results:In this research,16 pigs developed MODS among the total animals,which including 11 experiental animals with two organs failure,4 pigs having three organs failure and 2 pigs suffering from four or more organs failure.In the second part,the concentration of TNF-αhad a significant increase,and maintained a high level in the bodies.The pancreatic tissue in this study also had obvious inflammatory reactions. TNF-αwas dramatically related to both of pancreatic MDA and pancreatic pathological scores.Conclusion:In this research,a successful model of MODS was established according to the"double-hit"theory.Besides the observation of the development of MODS,the formation ofpancreatitis in the course of MODS was understood further.The relevance between the change of cytokines and pancreatic damage was recongnized preliminarily.