Iimuro Y, Aoyama H, Yamamoto M, Sugahara K
First Department of Surgery, Yamanashi Medical College, Japan.
Jpn J Surg. 1991 Jul;21(4):412-22. doi: 10.1007/BF02470969.
We produced a septic model of rats in which lung water accumulation was developed. The degree of lung water accumulation was then compared with the hepatic energy status because the liver is not only a metabolic central organ but also one of the central organs of the reticulo-endothelial system (RES), and clinically, lung edema in sepsis seems to relate to failure of the RES. Three experimental models were examined to form lung water accumulation, namely: the lethal model, given E. coli 6.0 X 10(6) CFU/g BW, the sublethal model, given E. coli 2.0 X 10(6) CFU/g BW, and the repeated sublethal dose injection model, given E. coli 2.0 X 10(6) X 2 at 12 hour intervals. In the lethal models, the energy charge (EC) of the liver decreased markedly (p less than 0.001) without recovery and the lung water accumulated (p less than 0.05). In the sublethal models, EC decreased transiently (p less than 0.05) and the lung water did not increase. However, when the microbial challenge with a sublethal dose was repeated, the decreases in EC were prolonged and the lung water increased significantly after the second injection (p less than 0.001) despite a 4.9 per cent mortality during the subsequent 24 hours. It is suggested that when the decrease in liver EC is prolonged, even if it is not fatal, an accumulation of lung water is possible in septic states. This finding may help further analyses of the interrelationship between the lung and the liver in severely infected patients.
我们构建了一个大鼠脓毒症模型，该模型中出现了肺水积聚。然后将肺水积聚程度与肝脏能量状态进行比较，因为肝脏不仅是一个代谢中心器官，也是网状内皮系统（RES）的中心器官之一，并且在临床上，脓毒症中的肺水肿似乎与RES功能衰竭有关。研究了三种形成肺水积聚的实验模型，即：致死模型，给予大肠杆菌6.0×10(6) CFU/g体重；亚致死模型，给予大肠杆菌2.0×10(6) CFU/g体重；重复亚致死剂量注射模型，每隔12小时给予大肠杆菌2.0×10(6)×2。在致死模型中，肝脏的能荷（EC）显著下降（p<0.001）且未恢复，同时肺水积聚（p<0.05）。在亚致死模型中，EC短暂下降（p<0.05），肺水未增加。然而，当用亚致死剂量重复进行微生物攻击时，EC的下降持续时间延长，并且在第二次注射后肺水显著增加（p<0.001），尽管在随后的24小时内有4.9%的死亡率。提示在脓毒症状态下，即使肝脏EC的下降不致命，但如果持续时间延长，仍可能出现肺水积聚。这一发现可能有助于进一步分析重症感染患者肺与肝之间的相互关系。
