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醋酸林格液和右旋糖酐林格液对脂多糖攻击后微循环的影响:仓鼠颊囊观察

Effects of Ringer-acetate and Ringer-dextran solutions on the microcirculation after LPS challenge: observations in the hamster cheek pouch.

作者信息

de Carvalho H, Dorigo D, Bouskela E

机构信息

Laboratório de Pesquisas em Microcirculação, Instituto de Biologia Roberto Alcantara Gomes, Rio de Janeiro, Brazil.

出版信息

Shock. 2001 Feb;15(2):157-62. doi: 10.1097/00024382-200115020-00013.

Abstract

The effects of NaCl 0.9%, Ringer-acetate, and Ringer-dextran given as intravenous infusions in the microcirculatory changes observed in early stages of endotoxemia were investigated in male hamsters treated with Escherichia coli lipopolysaccharide (LPS). The cheek pouch was studied in vivo by means of intravital microscopy. Mean arterial (MAP) and venous pressures (CVP), heart rate, mean arteriolar internal diameter, spontaneous arteriolar vasomotion (AV), red blood cell velocity (RBCV) in these vessels, and long-term effects of LPS were evaluated in animals treated with either LPS alone or the combination of LPS with NaCl 0.9%, Ringer-acetate and Ringer-dextran. The intravenous injection of LPS (0.3 mg/kg) elicited a significant reduction in MAP and CVP, cessation of AV and a decrease in RBCV. In our study, the heart rate and the arteriolar diameter did not change significantly, compared with the control values obtained before the LPS injection. No improvement in the MAP could be detected with infusions of NaCl 0.9% or Ringer-acetate but the infusion of Ringer-dextran increased it significantly. All infusions tested maintained the CVP until the end of the observation period and the Ringer-dextran increased it significantly. The heart rate was maintained around 360 beats/min with a tendency to decrease 70 min after the LPS infusion in all groups studied except the group which received NaCl 0.9% where the heart rate decreased significantly. In all the four groups, the mean arteriolar diameter did not change significantly with time during the observed period. RBCV decrease with the combination LPS + NaCl 0.9% and the infusions of Ringer-acetate and Ringer-dextran maintained it until the end of the observation period. The combination of LPS + NaCl 0.9% maintained the spontaneous arteriolar vasomotion during 50 min after LPS injection and the infusion of Ringer-acetate maintained it for the 3-h observation period. The infusion of Ringer-dextran maintained the amplitude of the spontaneous arteriolar vasomotion and increased its frequency significantly. The long-term effects of LPS showed weight loss and pus on the periorbital area. Our results suggest that the best solution to maintain the microcirculatory parameters during the early stage of endotoxemia after LPS injection was the Ringer-dextran.

摘要

在接受大肠杆菌脂多糖(LPS)治疗的雄性仓鼠中,研究了静脉输注0.9%氯化钠溶液、醋酸林格液和右旋糖酐林格液对内毒素血症早期微循环变化的影响。通过活体显微镜对颊囊进行体内研究。在单独给予LPS或LPS与0.9%氯化钠溶液、醋酸林格液和右旋糖酐林格液联合给药的动物中,评估平均动脉压(MAP)、中心静脉压(CVP)、心率、平均小动脉内径、小动脉自发血管运动(AV)、这些血管中的红细胞速度(RBCV)以及LPS的长期影响。静脉注射LPS(0.3mg/kg)导致MAP和CVP显著降低、AV停止以及RBCV下降。在我们的研究中,与LPS注射前获得的对照值相比,心率和小动脉直径没有显著变化。输注0.9%氯化钠溶液或醋酸林格液未检测到MAP改善,但输注右旋糖酐林格液使其显著升高。所有测试的输注液在观察期结束前均维持CVP,且右旋糖酐林格液使其显著升高。除接受0.9%氯化钠溶液的组心率显著下降外,在所有研究组中,LPS输注70分钟后心率维持在约360次/分钟且有下降趋势。在所有四组中,观察期内平均小动脉直径随时间无显著变化。LPS与0.9%氯化钠溶液联合使用以及输注醋酸林格液和右旋糖酐林格液可使RBCV下降并维持至观察期结束。LPS与0.9%氯化钠溶液联合使用在LPS注射后50分钟内维持小动脉自发血管运动,输注醋酸林格液在3小时观察期内维持该运动。输注右旋糖酐林格液维持小动脉自发血管运动的幅度并显著增加其频率。LPS的长期影响表现为体重减轻和眶周区域出现脓液。我们的结果表明,LPS注射后内毒素血症早期维持微循环参数的最佳溶液是右旋糖酐林格液。

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