Baker C C, Niven-Fairchild T, Caragnano C, Kupper T S
Department of Surgery, Yale University School of Medicine, New Haven, Connecticut 06510.
J Surg Res. 1991 Feb;50(2):170-4. doi: 10.1016/0022-4804(91)90242-e.
This study examined the effect of sepsis following trauma in a reproducible model of sepsis--cecal ligation and puncture (CLP)--in endotoxin-sensitive (C3H/HeN) and endotoxin-resistant (CeH/HeJ) mice. Studies used CLP with a 25-gauge needle at different time intervals following injury, as induced by femur fracture (FF), to determine the effects of sublethal sepsis on survival after trauma. There was a 3% mortality for FF alone in both groups. Mortality in C3H/HeJ mice was not significantly increased over FF alone except when CLP followed FF by 3 days (45%, P less than 0.02, Chi-square). In contrast, C3H/HeN mice had significantly increased mortality rates (75 to 90%, P less than 0.001) versus FF alone at all intervals between FF and CLP. Mortality for FF plus CLP was significantly greater for C3H/HeN compared to C3H/HeJ (P less than 0.001) for all time intervals between FF and CLP. In conclusion, animals exposed to a septic episode following FF had significantly greater mortality than FF animals without a septic challenge. Endotoxin-sensitive mice had significantly higher mortality after CLP and significantly increased mortality when CLP followed FF (regardless of timing) compared to endotoxin-resistant mice.
本研究在可重复的脓毒症模型——盲肠结扎穿孔（CLP）模型中，对内毒素敏感（C3H/HeN）和内毒素抵抗（C3H/HeJ）小鼠，检测了创伤后脓毒症的影响。研究采用25号针头在股骨骨折（FF）致伤后的不同时间间隔进行CLP，以确定亚致死性脓毒症对创伤后存活的影响。两组单纯FF的死亡率均为3%。C3H/HeJ小鼠的死亡率除了在FF后3天进行CLP时（45%，P<0.02，卡方检验）显著高于单纯FF外，其他情况均未显著增加。相比之下，在FF与CLP之间的所有时间间隔，C3H/HeN小鼠的死亡率相较于单纯FF均显著增加（75%至90%，P<0.001）。在FF与CLP之间的所有时间间隔，C3H/HeN小鼠FF加CLP的死亡率显著高于C3H/HeJ小鼠（P<0.001）。总之，FF后经历脓毒症发作的动物死亡率显著高于未接受脓毒症挑战的FF动物。与内毒素抵抗小鼠相比，内毒素敏感小鼠在CLP后的死亡率显著更高，且当CLP在FF之后（无论时间）时死亡率显著增加。
