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丙酮酸钠在全身炎症中的保护作用仅限于纠正代谢性酸中毒。

Protective Effects of Sodium Pyruvate during Systemic Inflammation Limited to the Correction of Metabolic Acidosis.

机构信息

Institute of Physiological Chemistry, University Hospital Essen, Hufelandstraße 55, 45122, Essen, Germany.

Clinic for Anesthesiology and Intensive Care, University Hospital Essen, Hufelandstraße 55, 45122, Essen, Germany.

出版信息

Inflammation. 2019 Apr;42(2):598-605. doi: 10.1007/s10753-018-0917-1.

Abstract

Protective effects by exogenous sodium pyruvate already have been described in various experimental models of injury, among others during intestinal ischemia-reperfusion injury, hemorrhagic shock, and shock secondary to systemic inflammation (endotoxemic shock). Low doses of sodium pyruvate reduced signs of inflammation, enhanced systemic blood pressure, and ameliorated metabolic acidosis when administered in a prophylactic manner during endotoxemic shock. In the present study, we investigated whether low-dosed infusions of sodium pyruvate exhibited beneficial effects when applied therapeutically after the induction of systemic inflammation. Lipopolysaccharide was infused at a rate of 0.5 mg/kg × h over a period of 360 min to induce systemic inflammation in male Wistar rats. Sodium pyruvate (single dose 50 mg/kg × 15 min) was administered intravenously 180 and 270 min after starting of the lipopolysaccharide infusion. Systemic/vital parameters (e.g., systemic blood pressure and breathing rate) and blood/plasma parameters (e.g., acid-base parameters; electrolytes; glucose and lactate concentration; hemolysis; aminotransferase activities; and parameters of coagulation) were determined in regular intervals. Lipopolysaccharide infusion led to metabolic acidosis, hypoglycemia, electrolyte as well as hemostatic disturbances, and hemolysis. Except for the acid-base status (amelioration of metabolic acidosis) and the plasma chloride concentration (reduction of hyperchloremia), the additional infusion of sodium pyruvate failed in significantly improving lipopolysaccharide-dependent alterations (e.g. vital, blood and plasma parameters). Protective effects of a delayed administration of the metabolizable anion pyruvate during systemic inflammation, hence, are limited to its function as alkalizer to counteract metabolic acidosis.

摘要

外源性丙酮酸钠的保护作用已在各种损伤的实验模型中得到描述,包括肠缺血再灌注损伤、失血性休克和全身炎症(内毒素性休克)继发的休克。在内毒素性休克中,低剂量的丙酮酸钠预防性给药可减轻炎症迹象,增强全身血压,并改善代谢性酸中毒。在本研究中,我们研究了在全身炎症诱导后进行治疗性低剂量输注丙酮酸钠是否具有有益作用。在 360 分钟内以 0.5mg/kg·h 的速度输注脂多糖,以诱导雄性 Wistar 大鼠全身炎症。在开始输注脂多糖后 180 和 270 分钟,静脉内给予丙酮酸钠(单次剂量 50mg/kg×15 分钟)。定期测定全身/生命参数(如全身血压和呼吸频率)和血液/血浆参数(如酸碱参数;电解质;血糖和乳酸浓度;溶血;氨基转移酶活性;和凝血参数)。脂多糖输注导致代谢性酸中毒、低血糖、电解质和止血紊乱以及溶血。除了酸碱状态(改善代谢性酸中毒)和血浆氯浓度(降低高氯血症)外,额外输注丙酮酸钠未能显著改善脂多糖依赖性改变(例如生命、血液和血浆参数)。因此,在全身炎症期间延迟给予可代谢阴离子丙酮酸的保护作用仅限于其作为碱化剂来对抗代谢性酸中毒的功能。

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