摘要目的 探讨血浆补体C5a和C5b-9是否能够预示大鼠创伤失血性休克时肝脏损害的严重程度.方法 50只雄性健康Wistar大鼠被随机(随机数字法)分为正常组、模型1,3,6,24 h组.用酶联免疫吸附方法(ELISA)检测血浆中总补体活性CH50、补体活性片断C5a和膜攻击复合物C5b9,速率法检测血浆中谷草转氨酶.石蜡切片观察肝脏病理损害.结果 在模型1 h时,CH50显著上升并且达到最高值,3 h开始下降,24 h时达到最低点,1 h与3,6,24 h时点相比较,差异具有统计学意义(P<0.05);在正常组血中可以检测到少量的C5b-9,在模型1 h时C5b-9显著上升达到峰值,与正常组、模型3,6,24 h相比较差异均具有统计学意义(P<0.05),3 h时C5b-9开始下降,模型24 h时降至最低;模型组3,6,24 h时点血浆中C5a开始上升,与正常组相比较,差异均具有统计学意义(P<0.05),模型24 h组达到峰值;谷草转氨酶在模型1 h显著上升,在24 h达到峰值,24 h组与其余模型组及正常组相比较差异具有统计学意义(P<0.05).结论 创伤失m性休克时存在补体的大量活化,早期CH50、C5b-9上升;后期C5a上升.可以认为C5b-9是肝脏损害的启动因素.早期低水平的C5a可能是机体的一种自我保护措施,后期高水平的C5a作为自身不能代偿后的一种表现,作为后期疾病严重程度的一项预测指标.

abstractsObjective To discuss the feasibility of using serum complement C5a and C5b-9 as predictive indicators of liver injury severity in traumatic rats with hemorrhagic shock.Method Fifry healthy male Wistar rats were randomly(random number)divided into normal group,model 1 hour group,model 3 hours group,model 6 hours group,and model 24 hours group.Plasma CH50,C5a and C5b-9 were detected by using enzyme-linked immunosorbent assay,and rate method was used for determination of plasma aspartate aminotransferase.Paraffin sections of hepatic tissues were used to observe the damage of liver.Results In the model l h group,the CH50 increased significantly and reached the highest value,it began to decline in 3 hours group,and it reached the lowest point in 24 hours group.Compared with the model 3 hours group,6 hours group,and 24 hours group,the level of CH50 in model 1 hour group increased more significantly(respectively P<0.05).A small amount of C5b-9 in the normal group was detected.In the model 1 h group,C5b-9 increased significantly and reach the peak compared with 3hours group,6hours group and 24 hours group,respectively(P<0.05),but in the model 3hours,it began to decline,and in 24 hours group,it reduced to minimum.C5a increased insignificantly in the model 3 hours group,6 hours group and 24 hours group,and peaked in 24 hours group compared with normal group(P<0.05).Aspartate aminotransferase in the model 1 hour group increased significantly and peaked in 24 hours group compared with other groups(P<0.05).Conclusions A large number of complements are activated in the seRing of hemorrhagie shock.C5b-9 and CH50 increase significantly in the early stage,and C5a.increases significantly in the later stage.C5b-9 can be considered as,an initiative factor of liver injury.The low levels of C5a in the early stage may be a mechanism of self-protection of the body.The high levels of CSa in the later stage may be a kind of decompensation,and C5a can be used as a late predictor of disease severity.