多器官功能衰竭(MOF) 是一種病因繁多、發病機制複雜、病死率極高的臨床綜合徵。 MOF 是指機體在經受嚴重損害（如嚴重疾病、外傷、手術、感染、休克等）後，發生兩個或兩個以上器官功能障礙，甚至功能衰竭的綜合徵。 MODS 是與應激密切相關的急性全身性器官功能損害。MOF 的發病機理非常複雜，多數觀點認為，儘管病因多種多樣，導致 MOF 發生髮展的機制是共同的。當機體經受打擊後，發生全身性自我破壞性炎性反應過程，稱為全身性炎性反應綜合徵（ Systemic Inflammatory Response Syndrome ， SIRS ）。在感染或無感染的情況下均可發生 SIRS ， SIRS 最終導致 MOF 。 治療 MOF 的主要措施 1.消除引起 MOF 的病因和誘因，治療原發疾病。 2.改善和維持組織充分氧合 3.保護肝、腎功能 4. 營養支持及代謝調理5. 合理應用抗生素。 6. 抗氧化劑、自由基清除劑的應用 7. 特異性治療。第四軍醫大學西京醫院麻醉科去年曾經發表 氫氣治療膿毒症 的文章，這個報導是上次文章的基礎上的進一步延伸。該研究採用酵母浸液腹腔注射誘導動物發生多器官功能衰竭，通過呼吸2%的氫氣，發現能有效提高動物生存率，提高器官抗氧化能力，減輕血液和器官炎症反應指標。研究說明氫氣呼吸能有效治療膿毒症之多器官功能衰竭，是一篇不可多得的優秀研究。值得學習，不過有一點遺憾的是，本研究採用的研究指標中有關於形態學的研究，但沒有提供相關照片，是比較遺憾，感覺數據中相對硬的指標不足。當然這不影響該論文的質量。
能在比較有影響力的休克雜誌上發表，也算是該研究水平的一個說明。該課題組在氫氣治療系統炎症方面的研究在國際上領先其他小組。到目前為止，關於採用呼吸氫氣治療疾病的研究仍不足10篇，其中這個小組已經發表2篇。日本今年的學術年會中，日本氫氣研究奠基人太田成男教授專門對他們的工作進行介紹，說明他們在氫氣生物學效應研究方面處於領先地位。
Shock. 2010 Mar 23. [Epub ahead of print]
Xie K , Yu Y , Zhang Z , Liu W , Pei Y , Xiong L , Hou L , Wang G.
1Department of Anesthesiology, General Hospital of Tianjin Medical University, Tianjin 300052, PR China. 2Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, Shaanxi Province, PR China. 3Department of Neurosurgery, Xijing Institute of Clinical Neuroscience, Xiing Hospital, Fourth Military Medical University, Xi’an 710032, Shaanxi Province, PR China.
Sepsis/Multiple organ dysfunction syndrome (MODS) is the leading cause of death in critically ill patients. Recently, it has been suggested that hydrogen gas (H2) exerts a therapeutic antioxidant activity by selectively reducing hydroxyl radical (.OH, the most cytotoxic ROS ). We have found that H2 inhalation significantly improved the survival rate and organ damage of septic mice with moderate or severe cecal ligation and puncture (CLP). In the present study, we investigated the effects of 2% H2 treatment on survival rate and organ damage in zymosan-induced generalized inflammation model. Here, we found that 2% H2 inhalation for 60 minutes starting at 1 and 6 hours after zymosan injection, respectively, significantly improved the 14-day survival rate of zymosan-challenged mice from 10% to 70%. Furthermore, zymosan-challenged mice showed significant multiple organ damage characterized by the increase of serum biochemical parameters (AST, ALT, BUN and Cr), as well as lung, liver and kidney histopathological scores at 24 hours after zymosan injection, which was significantly attenuated by 2% H2 treatment. In addition, we found that the beneficial effects of H2 treatment on zymosan-induced organ damage were associated with the decreased levels of oxidative product, increased activities of antioxidant enzyme as well as reduced levels of early and late proinflammatory cytokines in serum and tissues. In conclusion, this study provides evidence that H2 treatment protects against multiple organ damages in zymosan-induced generalized inflammation model, suggesting that the potential use of H2 as a therapeutic agent in the therapy of conditions associated with inflammation -related MODS.
PMID: 20351628 [PubMed – as supplied by publisher]
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