Correlation Of Blood Cells And Il-2, TNF-ɑ In Severe Traumatic-hemorrhagic Shock In Rats

Objective: To explore the mechanism of the pathological changes of blood cells in severe traumatic-hemorrhagic shock by dynamic measurement of routine blood , total protein, IL - 2, TNF-ɑin rats, and to evaluate the immune adjustive index in the earlier stage of the shock.Methods: Fourty-eight healthy male Sprague-Dawley SPF rats were randomly divided into two groups: normal control groups(NC, n=8) and traumatic-hemorrhagic shock groups(THS,n=40). In NC group, carotid artery and jugular vein were cannulated for blood pressure and sample collection. In THS group, the fracture, bloodletting and separation of femoral artery and femoral vein were added for seting up the severe traumatic-hemorrhagic shock model. The rats of THS group were subdivided as 5 subgroups (n=8), according to sample taking time points, at 1h, 2h, 4h, 8h and 16h after set up of the shock. Blood routine tests, total protein quantity and IL-2, TNF-ɑcontents in blood were examined from the inferior vena cava. All data were expressed as means±standard deviation((x|-)±s), and SPSS13.0 software was used for statistical analysis. The results in each traumatic-hemorrhagic shock subgroups were compared with normal controls by t-test, with P <0.05 significant difference and P <0.01 as very significant difference statistically.Results: 1. The changes of vital signs: The control values of MAP, HR and T were 125.03±0.52 mmHg, 481/min, 38.7℃respectively. There were no significant differences among 5 subgroups in all vital signs(P>0.05). There were significant differences in HR between controls and shock group when MAP was maintained at 30±5mmHg (P<0.05). Anus temperature was declined in each THS subgroups with the prolonged time of shock and were significantly different fromcontrols (P<0.01). 2. Routine test of peripheric blood : There were a decending tendency in red blood cells, platelates and other blood contents in THS group but without stastically significant difference from those of controls (P>0.05). The lymphocytes in THS groups were increased to the highest level at 2 hours after shock, then began to decline gradually until death(P<0.01, compared with controls). Mononuclear cells declined continuously from the start of shock to death(P<0.01, compared with controls).3. The changes of IL-2, TNF-ɑand TPB contents: IL-2 began to sharply decline at 1 hour after shock, then it continued to reduce with time extension. The content of TNF-ɑin blood serum increased at 1hour, decreased slightly at 2 hour, and increased again at 4 hour after shock(P>0.05). The TPB contents declined significantly at 1 hour after shock and kept at a low level till to death. There were no significant difference amont all subgroups of THS group(P>0.05).4. The correlation of IL-2, TNF-ɑ, TPB and blood routine test : The changes of lymphocytes and mononuclear cells were positively correlated with that of IL-2, but were not significantly correlated with the variational those of TNF-αand TBP.Conclusion: 1. The body stress reaction leads to dramatic rise of leukocyte after severe trauma clinically. Since the contents of TBP, all blood cells and volume decline dramatically after severe traumatic-hemorrhagic shock, routine blood test can not evaluate correctly the degree of stress response.2. The result shows the positive correlation of lymphocytes, mononuclear cells with IL-2 after severe traumatic-hemorrhagic shock, which indicates that the disability of immune adjustment function is the main reason in causing det erioration at the early stage of severe traumatic-hemorrhagic shock, not the promotive inflammatory factors.3. Clinically, rediative immune analysis (RIA) is commonly used for examinaton of T-cells subsets(CD3~+,CD4~+,CD8~+), IL-2. However RIA is complicated and time-consuming, and is not suitable for quick diagnosis. The result of the study indicates that the changes of lymphocytes and mononuclear cells in routine blood test may offer quick reliable index for immune adjustment function.