Sánchez Elisabet, Such José, Chiva Maite Teresa, Soriano Germán, Llovet Teresa, Mercè Javier, Sancho Francisco, Muñoz Carlos, Song Xiao-yu, Pérez-Mateo Miguel, Balanzó Joaquín, Guarner Carlos
Liver Unit, Hospital de la Santa Creu i Sant Pau, Autonomous University, Barcelona, Spain.
Am J Gastroenterol. 2007 Jun;102(6):1230-6. doi: 10.1111/j.1572-0241.2007.01182.x.
Spontaneous bacterial peritonitis (SBP) is a severe complication of cirrhotic patients associated with a high mortality.
To develop an available experimental model of induced bacterial peritonitis in cirrhosis.
Sprague-Dawley rats with carbon-tetrachloride-induced cirrhosis with (N=22) or without (N=101) ascites were randomized to receive an intraperitoneal administration of different concentrations of Escherichia coli (E. coli) diluted in 1 mL of sterile water in ascitic rats and in different volumes in nonascitic rats. A subgroup of nonascitic animals received ceftriaxone 4 h after E. coli inoculation. Mortality of rats was evaluated 24 h after bacterial inoculation.
None of the rats receiving sterile water alone and only one infected with 10(7) cfu of E. coli died. Ascitic rats showed a lower mortality rate than nonascitic rats infected with 10(8) or 10(9) cfu of E. coli (P<0.05). Mortality was higher with 10(9) cfu than with 10(8) cfu of E. coli in ascitic (P NS) and nonascitic (P<0.01) rats. A trend was noted to ward higher mortality in nonascitic rats inoculated with 10(8) cfu with increasing water volumes. A marked peritoneal polymorphonuclear cell response was observed 4 h after E. coli injection in both ascitic and nonascitic rats. Antibiotic therapy significantly reduced the mortality rate of rats infected with 10(8) cfu (P<0.01).
This experimental model of induced bacterial peritonitis in cirrhosis with or without ascites may represent a useful tool for the study of pathogenic events postinfection and for the design of new therapeutic strategies to treat patients with SBP.
自发性细菌性腹膜炎(SBP)是肝硬化患者的一种严重并发症,死亡率很高。
建立一种可行的肝硬化诱导性细菌性腹膜炎实验模型。
将用四氯化碳诱导肝硬化且有腹水(N=22)或无腹水(N=101)的Sprague-Dawley大鼠随机分组,在有腹水的大鼠中腹腔注射用1 mL无菌水稀释的不同浓度大肠杆菌(E. coli),在无腹水的大鼠中注射不同体积的上述菌液。一组无腹水动物在接种大肠杆菌4小时后接受头孢曲松治疗。在细菌接种24小时后评估大鼠死亡率。
仅接受无菌水的大鼠和仅感染10⁷ cfu大肠杆菌的大鼠均未死亡。有腹水的大鼠死亡率低于感染10⁸或10⁹ cfu大肠杆菌的无腹水大鼠(P<0.05)。在有腹水(P无显著性差异)和无腹水(P<0.01)的大鼠中,感染10⁹ cfu大肠杆菌的死亡率高于感染10⁸ cfu大肠杆菌的死亡率。在接种10⁸ cfu大肠杆菌的无腹水大鼠中,随着注射水量增加,死亡率有升高趋势。在大肠杆菌注射4小时后,在有腹水和无腹水的大鼠中均观察到明显的腹膜多形核细胞反应。抗生素治疗显著降低了感染10⁸ cfu大鼠的死亡率(P<0.01)。
这种有或无腹水的肝硬化诱导性细菌性腹膜炎实验模型可能是研究感染后致病过程以及设计治疗SBP患者新治疗策略的有用工具。