Schmeck J, Heller A, Phan T L, Urbschek R, Koch T
Department of Anaesthesiology and Intensive Care Medicine, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Germany.
Eur J Anaesthesiol. 1999 Mar;16(3):169-75. doi: 10.1046/j.1365-2346.1999.00445.x.
As elevated endothelin-1 (ET-1) levels have been reported in systemic inflammatory diseases, the role of ET-1 as a promoter of inflammatory reactions is currently under investigation. The purpose of this study was to investigate the potential influence of ET-1 on systemic vascular pressure and immune function in terms of blood clearance and organ distribution of injected Escherichia coli in a rabbit model. To enable quantification of the clearance process, defined numbers of exogenous E. coli (10(8) cfu) were injected intravenously 60 min after starting the infusion of ET-1 (0.2 microgram kg-1 min-1; n = 9) or after saline infusion (controls, n = 9). Parameters monitored were arterial blood pressure, airway pressure, serum lactate concentrations and rates of bacterial elimination from the blood. At 180 min after E. coli injection, the animals were killed, and tissue samples of liver, kidney, spleen and lung were collected for bacterial counts. ET-1 infusion produced an increase in mean arterial pressure (83.9 +/- 3.9 mmHg vs. 50.1 +/- 4.1 mmHg at 120 min; P < 0.01) associated with higher serum lactate concentrations (12.6 +/- 1.3 vs. 5.4 +/- 0.3 mg dL-1; P < 0.001) and a delayed bacterial elimination from the blood compared with controls. Furthermore, there was increased colonization of the lungs (3.6 +/- 0.5 x 10(3) cfu vs. 745 +/- 120 cfu; P < 0.01), spleen (142.4 +/- 45.4 x 10(3) cfu vs. 227 +/- 5.2 x 10(3) cfu; P < 0.05) and kidney (758 +/- 329 vs. 357 +/- 151 cfu; NS), reflecting a reduced bacterial killing function.
由于在全身性炎症疾病中已报道内皮素 -1(ET-1)水平升高,目前正在研究ET-1作为炎症反应促进因子的作用。本研究的目的是在兔模型中,就注射大肠杆菌后的血液清除和器官分布而言,研究ET-1对全身血管压力和免疫功能的潜在影响。为了能够对清除过程进行量化,在开始输注ET-1(0.2微克·千克⁻¹·分钟⁻¹;n = 9)60分钟后或输注生理盐水后(对照组,n = 9),静脉注射确定数量的外源性大肠杆菌(10⁸ cfu)。监测的参数包括动脉血压、气道压力、血清乳酸浓度以及血液中细菌清除率。在注射大肠杆菌180分钟后,处死动物,并收集肝脏、肾脏、脾脏和肺的组织样本进行细菌计数。输注ET-1导致平均动脉压升高(120分钟时为83.9±3.9 mmHg,而对照组为50.1±4.1 mmHg;P < 0.01),同时血清乳酸浓度更高(12.6±1.3 vs. 5.4±0.3 mg dL⁻¹;P < 0.001),并且与对照组相比,血液中细菌清除延迟。此外,肺部(3.6±0.5×10³ cfu vs. 745±120 cfu;P < 0.01)、脾脏(142.4±45.4×10³ cfu vs. 227±5.2×10³ cfu;P < 0.05)和肾脏(758±329 vs. 357±151 cfu;无显著性差异)的细菌定植增加,反映出细菌杀伤功能降低。