Powell R J, Machiedo G W, Rush B F, Dikdan G
Department of Surgery, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark 07103.
Crit Care Med. 1991 May;19(5):732-5.
To examine the effect of alpha-tocopherol, a free radical scavenger, on RBC deformability, mixed venous hemoglobin saturation (SvO2), arterial-venous oxygen content difference (C[a-v]O2), pHv, and survival during sepsis.
Randomized controlled study.
Sprague-Dawley rats were randomized to three groups: sham, cecal ligation and puncture, or alpha-tocopherol/cecal ligation and puncture (pretreatment with alpha-tocopherol before cecal ligation and puncture).
The cecal ligation and puncture group had a significantly (p less than .05) higher SvO2 and lower C (a-v)O2, pHv, and survival rate when compared with alpha-tocopherol/cecal ligation and puncture and sham groups. No difference in pHa existed between groups.
The alpha-tocopherol treatment improves survival in sepsis. RBC deformability during sepsis is prevented by alpha-tocopherol, suggesting that free radicals may cause the decrease in RBC deformability. This study provides indirect evidence that decreased RBC deformability may play a role in the physiologic peripheral shunting and decreased microcirculatory flow that occurs during sepsis.
研究自由基清除剂α-生育酚对脓毒症期间红细胞变形性、混合静脉血氧饱和度（SvO2）、动静脉血氧含量差（C[a-v]O2）、静脉血pH值（pHv）及生存率的影响。
随机对照研究。
将Sprague-Dawley大鼠随机分为三组：假手术组、盲肠结扎穿孔组或α-生育酚/盲肠结扎穿孔组（在盲肠结扎穿孔前用α-生育酚预处理）。
与α-生育酚/盲肠结扎穿孔组和假手术组相比，盲肠结扎穿孔组的SvO2显著升高（p<0.05），而C（a-v）O2、pHv及生存率显著降低。各组之间动脉血pH值（pHa）无差异。
α-生育酚治疗可提高脓毒症患者的生存率。α-生育酚可防止脓毒症期间红细胞变形性降低，提示自由基可能导致红细胞变形性下降。本研究提供了间接证据，表明红细胞变形性降低可能在脓毒症期间发生的生理性外周分流和微循环血流减少中起作用。
