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大麻素拮抗剂AM281对内毒素休克模型中循环系统恶化和细胞因子产生的影响:与去甲肾上腺素的比较。

Effects of AM281, a cannabinoid antagonist, on circulatory deterioration and cytokine production in an endotoxin shock model: comparison with norepinephrine.

作者信息

Kadoi Yuji, Goto Fumio

机构信息

Department of Anesthesiology, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, 371-8511, Japan.

出版信息

J Anesth. 2006;20(4):284-9. doi: 10.1007/s00540-006-0428-3.

Abstract

PURPOSE

The purpose of this study was to examine the comparative effects of AM281, a cannabinoid antagonist, and norepinephrine (NE) on systemic hemodynamics, and renal and mesenteric artery blood flow in an endotoxin shock model.

METHODS

The study was designed to include two sets of experiments: (1) measurements of changes in systemic hemodynamics and organ artery blood flows (n = 20), and (2) measurements of biochemical variables (n = 20). For each set of experiments, male 7-week-old Wistar rats were randomly divided into four groups: group 1, controls (n = 5); group 2, receiving lipopolysaccharide (LPS: Escherichia coli endotoxin, 10.0 mg.kg(-1) intravenous bolus) (n = 5); group 3, receiving intravenous LPS and NE (continuous infusion at 0.2 microg.kg.min(-1)) (n = 5); group 4, receiving LPS and AM281 (0.1 mg.kg.min(-1)) (n = 5). Systemic hemodynamics, regional artery blood flow changes, and biochemical variables were assessed before treatment and 1 and 3 h after treatment.

RESULTS

Infusion of NE or AM281 prevented endotoxin-induced decreases in systemic arterial pressure, aortic blood flow, carotid artery blood flow, and renal artery blood flow. Both AM281 and NE inhibited endotoxin-induced increases in cytokine production, with significant differences observed among the three groups at 1 and 3 h after treatment. Endotoxin-induced decreases in mesenteric arterial blood flow were restored by AM281 but not by NE. AM281 improved arterial oxygenation and reduced lactate overproduction and body temperature elevation induced by endotoxin.

CONCLUSIONS

Although NE and AM281 both prevented endotoxin-induced deterioration of systemic hemodynamics, AM281 yielded better preservation of mesenteric blood flow and attenuation of cytokine production than NE.

摘要

目的

本研究旨在探讨大麻素拮抗剂AM281和去甲肾上腺素(NE)对内毒素休克模型中全身血流动力学以及肾和肠系膜动脉血流量的比较影响。

方法

本研究设计了两组实验:(1)测量全身血流动力学和器官动脉血流量的变化(n = 20),以及(2)测量生化变量(n = 20)。对于每组实验,将7周龄雄性Wistar大鼠随机分为四组:第1组,对照组(n = 5);第2组,接受脂多糖(LPS:大肠杆菌内毒素,10.0 mg·kg⁻¹静脉推注)(n = 5);第3组,接受静脉注射LPS和NE(以0.2 μg·kg·min⁻¹持续输注)(n = 5);第4组,接受LPS和AM281(0.1 mg·kg·min⁻¹)(n = 5)。在治疗前以及治疗后1小时和3小时评估全身血流动力学、局部动脉血流量变化和生化变量。

结果

输注NE或AM281可防止内毒素引起的全身动脉压、主动脉血流量、颈动脉血流量和肾动脉血流量下降。AM281和NE均抑制内毒素诱导的细胞因子产生增加,治疗后1小时和3小时三组之间观察到显著差异。AM281可恢复内毒素引起的肠系膜动脉血流量下降,而NE则不能。AM281改善了动脉氧合,并减少了内毒素诱导的乳酸过度产生和体温升高。

结论

虽然NE和AM281均能防止内毒素引起的全身血流动力学恶化,但与NE相比,AM281能更好地保存肠系膜血流量并减轻细胞因子产生。

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