Sessler C N, Glauser F L, Davis D, Fowler A A
Department of Medicine, Medical College of Virginia, Richmond.
J Appl Physiol (1985). 1988 Dec;65(6):2624-31. doi: 10.1152/jappl.1988.65.6.2624.
We investigated whether platelet-activating factor (PAF) mediates endotoxin-induced systemic and pulmonary vascular derangements by studying the effects of a selective PAF receptor antagonist, SRI 63-441, during endotoxemia in sheep. Endotoxin infusion (1.3 micrograms/kg over 0.5 h) caused a rapid, transient rise in pulmonary arterial pressure (Ppa) from 16 +/- 3 to 36 +/- 10 mmHg (P less than 0.001) and pulmonary vascular resistance (PVR) from 187 +/- 84 to 682 +/- 340 dyn.s.cm-5 (P less than 0.05) at 0.5 h, followed by a persistent elevation in Ppa to 22 +/- 3 mmHg and in PVR to 522 +/- 285 dyn.s.cm-5 at 5 h in anesthetized sheep. Arterial PO2 (PaO2) decreased from 341 +/- 79 to 198 +/- 97 (P less than 0.01) and 202 +/- 161 Torr at 0.5 and 5 h, respectively (inspired O2 fraction = 1.0). SRI 63-441, 20 mg.kg-1.h-1 infused for 5 h, blocked the early rise in Ppa and PVR and fall in PaO2, but had no effect on the late phase pulmonary hypertension or hypoxemia. Endotoxin caused a gradual decrease in mean aortic pressure, which was unaffected by SRI 63-441. Infusion of SRI 63-441 alone caused no hemodynamic alterations. In follow-up studies, endotoxin caused an increase in lung lymph flow (QL) from 3.8 +/- 1.1 to 14.1 +/- 8.0 (P less than 0.05) and 12.7 +/- 8.6 ml/h at 1 and 4 h, respectively. SRI 63-441 abolished the early and attenuated the late increase in QL.(ABSTRACT TRUNCATED AT 250 WORDS)
我们通过研究选择性血小板活化因子(PAF)受体拮抗剂SRI 63 - 441在绵羊内毒素血症期间的作用,来探究PAF是否介导内毒素诱导的全身和肺血管紊乱。内毒素输注(0.5小时内输注1.3微克/千克)导致麻醉绵羊在0.5小时时肺动脉压(Ppa)从16±3迅速短暂升高至36±10 mmHg(P<0.001),肺血管阻力(PVR)从187±84升高至682±340 dyn.s.cm⁻⁵(P<0.05),随后在5小时时Ppa持续升高至22±3 mmHg,PVR升高至522±285 dyn.s.cm⁻⁵。动脉血氧分压(PaO₂)分别在0.5小时和5小时时从341±79降至198±97(P<0.01)和202±161 Torr(吸入氧分数=1.0)。以20毫克·千克⁻¹·小时⁻¹的剂量输注SRI 63 - 441达5小时,可阻断Ppa和PVR的早期升高以及PaO₂的降低,但对后期的肺动脉高压或低氧血症无影响。内毒素导致平均主动脉压逐渐降低,这不受SRI 63 - 441影响。单独输注SRI 63 - 441未引起血流动力学改变。在后续研究中,内毒素导致肺淋巴流量(QL)在1小时和4小时时分别从3.8±1.1增加至14.1±8.0(P<0.05)和12.7±8.6毫升/小时。SRI 63 - 441消除了QL的早期增加并减弱了后期增加。(摘要截短于250字)