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手术创伤对炎症反应的调节作用:与皮质类固醇分泌无关。

Modulation of inflammatory reactions by surgical trauma: lack of relationship with corticosteroid secretion.

作者信息

Kinnaert P, Van Geertruyden N, DePauw L, Van Gansbeke B, Bournonville B, DeCoster-Gervy C

出版信息

World J Surg. 1989 Jul-Aug;13(4):478-83. doi: 10.1007/BF01660762.

Abstract

The effect of surgery on inflammation was studied in male Wistar R/A rats using the carrageenin-induced edema model. Swelling of the paw was measured in standardized arbitrary units 2, 4, and 6 hr after a subcutaneous injection of carrageenin iota in the subplantar region of the right hind limb. It was significantly depressed in rats submitted to laparotomy (5.0 +/- 0.4, 8.0 +/- 1.0, 13.7 +/- 1.9) when compared with controls simply anesthetized with ether (6.2 +/- 0.5, 15.5 +/- 1.2, 23.7 +/- 0.6) (p less than 0.001 at 4 and 6 hr). This inhibition lasted for at least 24 hr and was also observed after amputation, although in these experiments, the difference between operated animals and controls was not significant. Alterations of the inflammatory cellular infiltrate were studied using polyurethane sponges soaked with carrageenin lambda implanted subcutaneously in control animals and rats undergoing laparotomy or amputation. The total number of cells recovered from these sponges 5 hr after implantation was smaller in operated rats (2.9 +/- 0.4 x 10(6) cells after laparotomy, 3.1 +/- 1.0 x 10(6) cells after amputation) when compared with controls (11.1 +/- 1.9 x 10(6) cells and 10.3 +/- 1.3 x 10(6) cells) (p less than 0.001 for laparotomy and p less than 0.005 for amputation). The inhibitory effect of operative trauma was not abolished by bilateral adrenalectomy performed 12 days before laparotomy. In rats, surgical trauma induces a depression of remote inflammatory reactions. This phenomenon is not related to increased corticosterone levels.

摘要

利用角叉菜胶诱导的水肿模型,在雄性Wistar R/A大鼠中研究了手术对炎症的影响。在右后肢足底皮下注射角叉菜胶iota后2、4和6小时,以标准化的任意单位测量爪部肿胀情况。与仅用乙醚麻醉的对照组相比,接受剖腹手术的大鼠(5.0±0.4、8.0±1.0、13.7±1.9)肿胀明显减轻(对照组为6.2±0.5、15.5±1.2、23.7±0.6)(4小时和6小时时p<0.001)。这种抑制作用持续至少24小时,截肢后也观察到了这种情况,不过在这些实验中,手术动物与对照组之间的差异不显著。使用浸泡有角叉菜胶λ的聚氨酯海绵皮下植入对照动物以及接受剖腹手术或截肢的大鼠,研究炎症细胞浸润的变化。植入5小时后,从这些海绵中回收的细胞总数,手术大鼠(剖腹手术后为2.9±0.4×10⁶个细胞,截肢后为3.1±1.0×10⁶个细胞)比对照组(11.1±1.9×10⁶个细胞和10.3±1.3×10⁶个细胞)少(剖腹手术p<0.001,截肢p<0.005)。剖腹手术前12天进行双侧肾上腺切除术并不能消除手术创伤的抑制作用。在大鼠中,手术创伤会导致远处炎症反应受到抑制。这种现象与皮质酮水平升高无关。

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