Brock-Utne J G, Gaffin S L
Department of Physiology and Biochemistry, University of Natal Medical School, Durban, South Africa.
Anaesth Intensive Care. 1989 Feb;17(1):49-55. doi: 10.1177/0310057X8901700111.
Endotoxins (lipopolysaccharides, LPS) are potent bacterial poisons always present within the intestines in considerable amounts. Several pathophysiological conditions such as hypovolaemia, hypoxia, intestinal ischaemia, burns and radiation lead to a breakdown in the barrier and depending upon the extent of the injury, endotoxins enter the systemic circulation in increasing amounts. Antibiotics do not inactivate the endotoxins which continue to exert their toxic effects leading to nausea, vomiting, diarrhoea, fever, disseminated intravascular coagulation, vascular collapse and organ failure. When nonabsorbable antibiotics are given prior to the insult, systemic endotoxaemia is prevented. Immunotherapy, using anti-lipopolysaccharide IgG, inactivates plasma endotoxins, destroys gram-negative bacteria and opsonises them and may become a major form of therapy. An outline of endotoxin and anti-lipopolysaccharide and its importance to the anaesthetist and intensive care specialist is presented.
内毒素（脂多糖，LPS）是强效的细菌毒素，在肠道内总是大量存在。几种病理生理状况，如低血容量、缺氧、肠道缺血、烧伤和辐射，会导致屏障破坏，根据损伤程度，内毒素会以越来越多的量进入体循环。抗生素不会使内毒素失活，内毒素会继续发挥其毒性作用，导致恶心、呕吐、腹泻、发热、弥散性血管内凝血、血管塌陷和器官衰竭。在受到损伤之前给予不可吸收的抗生素，可以预防全身性内毒素血症。使用抗脂多糖IgG的免疫疗法可使血浆内毒素失活，破坏革兰氏阴性菌并使其成为调理素，可能会成为一种主要的治疗方式。本文概述了内毒素和抗脂多糖及其对麻醉医生和重症监护专家的重要性。
