Singh G, Chaudry K I, Chudler L C, Chaudry I H
Department of Surgery, Michigan State University, East Lansing 48824.
Am J Physiol. 1992 Jul;263(1 Pt 2):R19-23. doi: 10.1152/ajpregu.1992.263.1.R19.
Although gut permeability increases and bacterial translocation occurs under certain pathological conditions, it remains unknown whether gut absorptive capacity (GAC) is altered early after the onset of sepsis. The aim of the present study was to investigate this and also to determine whether diltiazem has any effect on GAC in early sepsis. Rats were lightly anesthetized and cecal ligation and puncture (CLP) was performed. A nasogastric tube was inserted, cannulation of various blood vessels was carried out, and the animals were allowed to recover from anesthesia. One hour after CLP, one group of animals received a 1-ml bolus of normal saline intravenously, and another group received diltiazem, 400 micrograms/kg body wt. Sham animals had no CLP performed. GAC was determined by the D-xylose absorption test at 2 and 4 h after CLP. One hour after the administration of D-xylose via the nasogastric tube, its concentration in portal blood was determined colorimetrically. Results show that GAC is significantly depressed at 2 and 4 h after CLP despite the maintenance of normal blood pressure, central venous pressure, and portal pressure. Administration of diltiazem restored GAC to normal levels at 4 h after CLP. Thus diltiazem is a useful adjuvant in the treatment of sepsis because it restores gut absorptive capacity to normal and allows for early enteral nutrition.
尽管在某些病理条件下肠道通透性会增加且细菌易位会发生，但脓毒症发作后早期肠道吸收能力（GAC）是否改变仍不清楚。本研究的目的是调查这一情况，并确定地尔硫䓬在早期脓毒症中对GAC是否有任何影响。将大鼠轻度麻醉后进行盲肠结扎和穿刺（CLP）。插入鼻胃管，进行各种血管插管，然后让动物从麻醉中恢复。CLP后1小时，一组动物静脉注射1ml生理盐水，另一组动物接受地尔硫䓬，剂量为400微克/千克体重。假手术动物未进行CLP。通过在CLP后2小时和4小时进行的D-木糖吸收试验来测定GAC。通过鼻胃管给予D-木糖1小时后，用比色法测定其在门静脉血中的浓度。结果显示，尽管血压、中心静脉压和门静脉压维持正常，但CLP后2小时和4小时GAC显著降低。地尔硫䓬给药后，CLP后4小时GAC恢复到正常水平。因此，地尔硫䓬是脓毒症治疗中的一种有用佐剂，因为它能使肠道吸收能力恢复正常并允许早期肠内营养。
