Feng Xiaomei, Yan Wei, Liu Xiaoming, Duan Manlin, Zhang Xinhua, Xu Jianguo
Department of Anesthesiology Jinling Hospital, School of Medicine, Nanjing University, Nanjing, P. R. China.
J Surg Res. 2006 Sep;135(1):129-36. doi: 10.1016/j.jss.2006.02.028. Epub 2006 Apr 17.
Sepsis and resulting multiple system organ failure are the leading causes of mortality in intensive care units. Hydroxyethyl starch (HES) 130/0.4 was a novel preparation, developed to improve the pharmacokinetics of current medium molecular weight HES solutions. This study was designed to explore the effects of HES 130/0.4 on pulmonary capillary permeability (PCP), production of cytokines, and activation of transcription factor in septic rats induced by cecal ligation and puncture (CLP).
Adult male Sprague Dawley rats were randomly divided into six groups (six rats/group): saline controls (30 ml/kg); CLP plus saline (30 ml/kg); CLP plus HES (7.5, 15, or 30 ml/kg, respectively), and HES alone (30 ml/kg). Mean arterial blood pressure and heart rate were monitored during the experiment process. Myeloperoxidase (MPO) activity, wet/dry weight ratio, PCP, tumor necrosis factor alpha (TNF-alpha), interleukin (IL)-6, IL-10, and nuclear factor-kappa B (NF-kappaB) were investigated at 6 h.
We demonstrated that CLP could provoke significant injury in lung, characterized by increase in PCP, wet/dry weight ratio, MPO activity, TNF-alpha, IL-6, and IL-10 level, and NF-kappaB activation. Without obvious influence on systemic macro-hemodynamics, HES 15 ml/kg and 30 ml/kg significantly reduced CLP-induced elevation of pulmonary capillary permeability, wet/dry weight ratio, and production of IL-6. Meanwhile, HES 15 ml/kg increased IL-10 level and HES 7.5, 15, and 30 ml/kg suppressed MPO activity, TNF-alpha level, and NF-kappaB activation.
HES 130/0.4 can inhibit CLP-induced PCP by attenuating pulmonary inflammation and NF-kappaB activation in vivo.
脓毒症及由此导致的多系统器官功能衰竭是重症监护病房患者死亡的主要原因。羟乙基淀粉(HES)130/0.4是一种新型制剂,旨在改善当前中分子量HES溶液的药代动力学。本研究旨在探讨HES 130/0.4对盲肠结扎穿孔(CLP)诱导的脓毒症大鼠肺毛细血管通透性(PCP)、细胞因子产生及转录因子激活的影响。
成年雄性Sprague Dawley大鼠随机分为六组(每组6只):生理盐水对照组(30 ml/kg);CLP加生理盐水组(30 ml/kg);CLP加HES组(分别为7.5、15或30 ml/kg),以及单独给予HES组(30 ml/kg)。实验过程中监测平均动脉血压和心率。于6小时时检测髓过氧化物酶(MPO)活性、湿/干重比、PCP、肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-6、IL-10及核因子κB(NF-κB)。
我们发现CLP可引发显著的肺损伤,表现为PCP升高、湿/干重比增加、MPO活性增强、TNF-α、IL-6及IL-10水平升高以及NF-κB激活。在对全身宏观血流动力学无明显影响的情况下,15 ml/kg和30 ml/kg的HES显著降低了CLP诱导的肺毛细血管通透性升高、湿/干重比增加及IL-6产生。同时,15 ml/kg的HES增加了IL-10水平,7.5、15及30 ml/kg的HES抑制了MPO活性、TNF-α水平及NF-κB激活。
HES 130/0.4可通过减轻体内肺部炎症及NF-κB激活来抑制CLP诱导的PCP。