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多培沙明对大鼠脓毒症模型肠道微血管血流及白细胞活化的影响。

Effects of dopexamine on the intestinal microvascular blood flow and leukocyte activation in a sepsis model in rats.

作者信息

Birnbaum Jurgen, Klotz Edda, Spies Claudia D, Lorenz Bjorn, Stuebs Patrick, Hein Ortrud Vargas, Grundling Matthias, Pavlovic Dragan, Usichenko Taras, Wendt Michael, Kox Wolfgang J, Lehmann Christian

机构信息

Department of Anesthesiology and Intensive Care Medicine, Campus Charité Mitte, Charité-University Medicine, Berlin, Germany.

出版信息

Crit Care. 2006;10(4):R117. doi: 10.1186/cc5011.

Abstract

INTRODUCTION

The administration of dopexamine may constitute a therapeutical option to improve hepatosplanchnic perfusion in sepsis. In order to verify this hypothesis, we administered dopexamine in an experimental sepsis model in rats.

METHODS

This prospective, randomized, controlled laboratory study was conducted in 42 Wistar rats. The animals were divided into 3 groups. Group 1 (CON group) served as control group. The Animals of groups 2 (LPS Group) and 3 received an endotoxin infusion (20 mg/kgfor 15 min). In addition, in group 3 (DPX group) dopexamine was administered 0.5 microg/kg/minover 4 hours. One half of the animals of each group underwent studies of intestinal microvascular blood flow (IMBF) using laser Doppler fluxmetry. In the other half an intravital microscopic evaluation of the leukocyte endothelium cell interaction in the intestinal microcirculation was performed. Functional capillary denstity (FCD) in the intestinal mucosaand the circular as well as the longitudinal muscle layer was estimated.

RESULTS

One hour after endotoxin challenge IMBF decreased significantly in the untreated LPS group to 51% compared to baseline (p<0.05). In DPX treated endotoxin animals we found significantly higher values at the level of CON group. The after endotoxin challenge impaired FCD was improved by dopexamine in the longitudinal (DPX + 33% vs. LPS; p <0.05) and in the circular muscle layer (DPX + 48% vs. LPS; p < 0.05) as a result of dopexamine administration. The administration of dopexamine reduced the count of firmly adherent leukocytes when compared to the untreated LPS group (-31%, p<0.05). TNF-alpha plasma levels were reduced by dopexamine infusion (LPS group 3637 +/- 553 pg/mL; DPXgroup 1933 +/- 201 pg/mL) one hour after endotoxin challenge.

CONCLUSIONS

The administration of dopexamine improved IMBF and FCD as parameters of intestinal microcirculation and reduced leukocyte activation as a parameter of inflammation in experimental sepsis.

摘要

引言

使用多培沙明可能是改善脓毒症患者肝脾灌注的一种治疗选择。为了验证这一假设,我们在大鼠实验性脓毒症模型中使用了多培沙明。

方法

本前瞻性、随机、对照实验室研究共纳入42只Wistar大鼠。动物被分为3组。第1组(CON组)作为对照组。第2组(LPS组)和第3组动物接受内毒素输注(20mg/kg,持续15分钟)。此外,第3组(DPX组)在4小时内以0.5μg/kg/min的速度输注多培沙明。每组动物的一半使用激光多普勒血流仪进行肠微血管血流量(IMBF)研究。另一半对肠微循环中的白细胞内皮细胞相互作用进行活体显微镜评估。估计肠黏膜、环形肌层和纵行肌层的功能性毛细血管密度(FCD)。

结果

内毒素攻击1小时后,未治疗的LPS组IMBF与基线相比显著下降至51%(p<0.05)。在接受DPX治疗的内毒素动物中,我们发现其水平显著高于CON组。内毒素攻击后,多培沙明使纵向(DPX组比LPS组增加33%;p<0.05)和环形肌层(DPX组比LPS组增加48%;p<0.05)的FCD受损情况得到改善。与未治疗的LPS组相比,多培沙明的使用减少了牢固黏附白细胞的数量(-31%,p<0.05)。内毒素攻击1小时后,多培沙明输注降低了血浆TNF-α水平(LPS组3637±553pg/mL;DPX组1933±201pg/mL)。

结论

在实验性脓毒症中,多培沙明的使用改善了作为肠微循环参数的IMBF和FCD,并减少了作为炎症参数的白细胞活化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9ce/1750974/8a93dad3f3a4/cc5011-1.jpg

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