Traber D L, Adams T, Sziebert L, Traber L D
Resuscitation. 1986 Sep;14(1-2):91-104. doi: 10.1016/0300-9572(86)90009-2.
Gabexate mesilate (GM), a proteolytic enzyme inhibitor, was given to 31 chronically instrumented sheep either as a pretreatment or treatment to determine its effects on the cardiopulmonary response to endotoxin (ET). Twelve sheep received GM prior to endotoxin (0.75 microgram/kg), 10 after ET and 9 received GM without ET. A typical biphasic response was noted; phase I showed increased lymph flow (QL), reduced lymph to plasma protein ratio (L/P) and increased pulmonary artery pressure (PAP). Phase II occurred two hours after ET; the lymph flow remained elevated and the L/P ratio rose slightly above control. Both phases demonstrated an elevation in total peripheral vascular resistance (TPR) and hematocrit but a reduction in cardiac output (CO). In phase II, QL was reduced 35% with pretreatment; the L/P ratio did not rise as much and the PAP was unchanged. There was also a 35% reduction in lymph flow; no change in the lymph to plasma protein ratio but there was an elevation in pulmonary microvascular pressure. Pretreatment with GM diminished the fall in CO and the rise in TPR seen with endotoxin. The values were unaffected by treatment alone.
甲磺酸加贝酯（GM）是一种蛋白水解酶抑制剂，对31只长期植入仪器的绵羊进行预处理或治疗，以确定其对心肺对内毒素（ET）反应的影响。12只绵羊在内毒素（0.75微克/千克）之前接受GM，10只在ET之后接受GM，9只未接受ET仅接受GM。观察到典型的双相反应；第一阶段表现为淋巴流量（QL）增加、淋巴与血浆蛋白比率（L/P）降低以及肺动脉压（PAP）升高。第二阶段在ET后两小时出现；淋巴流量仍升高，L/P比率略高于对照。两个阶段均显示总外周血管阻力（TPR）和血细胞比容升高，但心输出量（CO）降低。在第二阶段，预处理使QL降低35%；L/P比率上升幅度不大，PAP不变。淋巴流量也降低了35%；淋巴与血浆蛋白比率无变化，但肺微血管压升高。GM预处理减轻了内毒素引起的CO下降和TPR升高。这些值不受单独治疗的影响。
