Demling R H, Knox J, Youn Y K, Daryani R, LaLonde C
Longwood Area Trauma Center, Boston, MA 02115.
Surgery. 1992 Jan;111(1):79-85.
beta-agonists are known to not only increase oxygen delivery, but also attenuate the inflammatory response. We studied the effect of infusing the beta-agonist, dobutamine, on the oxidant-induced lung and liver tissue lipid peroxidation seen after endotoxemia. Twelve unanesthetized adult sheep with lung and soft tissue (prefemoral) lymph fistulae were given 5 micrograms/kg of Escherichia coli endotoxin intravenously. In six sheep, dobutamine 10 to 15 micrograms/kg/min was infused beginning 3 hours after endotoxin to increase oxygen delivery by 75% above baseline. Animals were killed at 6 hours, and lung and liver lipid peroxidation, measured as malondialdehyde, was obtained. Data were compared to six control sheep. Endotoxin alone produced increased lung and soft tissue vascular permeability as evidenced by a twofold increase in protein-rich lymph flow. Lung and liver malondialdehyde increased to 116 +/- 40 nmol/gm and 202 +/- 64 nmol/gm, respectively, compared to control values of 42 +/- 7 nmol/gm and 110 +/- 20 nmol/gm, respectively. Dobutamine infusion after endotoxin increased oxygen delivery by 75%, although changes in total oxygen consumption were not different from those seen with endotoxin alone. Lung and soft tissue lymph flow did not change with dobutamine. However, lung malondialdehyde was 41 +/- 17 nmol/gm, not different from controls. Liver malondialdehyde remained elevated at 164 +/- 26 nmol/gm. We conclude that dobutamine infusion prevents further oxidant-induced lung tissue lipid peroxidation but does not reverse the increased permeability already present. Liver lipid peroxidation was not decreased, suggesting the liver oxidant process may not be caused by the same mechanism as the lung lipid peroxidation.
已知β-激动剂不仅能增加氧输送,还能减轻炎症反应。我们研究了输注β-激动剂多巴酚丁胺对内毒素血症后氧化应激诱导的肺和肝组织脂质过氧化的影响。给12只患有肺和软组织(股前)淋巴瘘的未麻醉成年绵羊静脉注射5微克/千克大肠杆菌内毒素。在6只绵羊中,内毒素注射3小时后开始输注10至15微克/千克/分钟的多巴酚丁胺,以使氧输送比基线增加75%。在6小时时处死动物,测定肺和肝脂质过氧化产物丙二醛含量。数据与6只对照绵羊进行比较。单独内毒素导致肺和软组织血管通透性增加,富含蛋白质的淋巴流量增加了两倍。与对照值分别为42±7纳摩尔/克和110±20纳摩尔/克相比,肺和肝丙二醛分别增加到116±40纳摩尔/克和202±64纳摩尔/克。内毒素后输注多巴酚丁胺使氧输送增加了75%,尽管总氧消耗的变化与单独使用内毒素时无差异。多巴酚丁胺对肺和软组织淋巴流量无影响。然而,肺丙二醛为41±17纳摩尔/克,与对照无差异。肝丙二醛仍升高至164±26纳摩尔/克。我们得出结论,输注多巴酚丁胺可防止氧化应激进一步诱导肺组织脂质过氧化,但不能逆转已存在的通透性增加。肝脂质过氧化未降低,提示肝氧化应激过程可能与肺脂质过氧化机制不同。