Lindquist O, Saldeen T, Sandler H
Acta Chir Scand. 1976;142(1):15-9.
In the present study the pathogenesis of the pulmonary damage following infusion of thrombin in combination with a fibrinolysis inhibitor, AMCA, in the dog was elucidated. An important mechanism in the development of the pulmonary damage following infusion of thrombin and AMCA seems to be an increased vascular permeability in the pulmonary microvasculature leading to pulmonary oedema. The question whether this pulmonary damage can be prevented by antihistamine (mepyramine maleate), antiserotonins (methysergide, reserpine) antiprostaglandins (acetylsalicylic acid, indomethacin, polyphloretin phosphate), 'anti-inflammatory agents' (methylprednisolone, calcium) or an anti-adrenergic agent (phenoxybenzamine) was investigated. None of these agents did prevent the lung damage following thrombin and AMCA. In order to study the possible role of bronchoconstriction, the complement system and the kinin system for this damage dogs were also artificially ventilated with an increased end-expiratory pressure, decomplemented with cobra venom factor or treated with Trasylol respectively. Neither were these treatments effective in preventing the pulmonary damage. The findings of the present study suggest that the permeability increasing substance involved in the pathogenesis of the pulmonary damage following thrombin and AMCA is not histamine, serotonin, prostaglandins or bradykinin. Therefore another, still unknown factor, may be of greater importance for this damage.
在本研究中,阐明了在犬体内输注凝血酶并联合纤溶抑制剂氨甲环酸(AMCA)后肺损伤的发病机制。输注凝血酶和AMCA后肺损伤发展的一个重要机制似乎是肺微血管系统中血管通透性增加,导致肺水肿。研究了抗组胺药(马来酸氯苯那敏)、抗5-羟色胺药(甲基麦角新碱、利血平)、抗前列腺素药(阿司匹林、吲哚美辛、聚磷酸根皮苷)、“抗炎药”(甲泼尼龙、钙)或抗肾上腺素能药(苯氧苄胺)能否预防这种肺损伤。这些药物均不能预防凝血酶和AMCA后的肺损伤。为了研究支气管收缩、补体系统和激肽系统在这种损伤中可能起的作用,还分别对犬进行了呼气末正压增加的人工通气、用眼镜蛇毒因子进行补体灭活或用抑肽酶进行治疗。这些治疗方法也均不能有效预防肺损伤。本研究结果表明,凝血酶和AMCA后肺损伤发病机制中涉及的通透性增加物质不是组胺、5-羟色胺、前列腺素或缓激肽。因此,另一种尚不清楚的因素可能对这种损伤更为重要。