van Lambalgen A A, Rasker M T, van den Bos G C, Thijs L G
Laboratory for Physiology, Free University Amsterdam, The Netherlands.
Microvasc Res. 1988 Nov;36(3):291-304. doi: 10.1016/0026-2862(88)90029-5.
Endotoxemia in rats increases plasma extravasation but does not result in continuously rising hematocrit. These contradictory observations led us to design a study in anesthetized rats (C, control rats, n = 10; E, endotoxin rats, n = 10) in which we continuously measured in blood hematocrit (conductivity cell) and changes in concentration of 125I-HSA (human serum albumin) and 51Cr-labeled red cell (51Cr-RBC; multichannel analyzer) in an extracorporeal circuit. In two additional series of experiments we measured in blood samples changes in protein concentration (series II, C: n = 7, E: n = 7) and uptake of intraperitoneally injected 125I-HSA and 51Cr-RBC (reflecting lymph flow rate; series III, C: n = 6, E: n = 7). Endotoxemia was induced by infusion (iv, 0.2 ml/100 g.hr) of Escherichia coli endotoxin (20 mg/kg) from t = 0 to t = 60 min; controls received saline. Experiments ended at t = 120 (series I and II) or 150 min (series III). The endotoxemia resulted in a marked rise of serum lactate (by ca 500% at t = 120); heart rate increased and central venous pressure decreased (by ca 20 and -95% at t = 120, respectively). All rats showed characteristic changes in hematocrit during endotoxemia: an increase from t = 20 to t = 45 (by ca 9%) followed by a decrease to preshock values or less at t = 120. The 51Cr activity per microliter blood cells did not change, indicating that there was no red cell mobilization. Protein concentration and 125I-HSA activity also showed a temporary increase during endotoxemia, but 125I-HSA activity per gram protein was decreased. Peritoneal uptake of 125I-HSA and 51Cr-RBC was significantly increased during endotoxemia (by 200%). We conclude that fluid extravasation during endotoxemia is temporary, mainly concerns plasma water, and is compensated by mechanisms like reabsorption and increased lymph flow, resulting in restoration of plasma volume.
大鼠内毒素血症会增加血浆外渗,但不会导致血细胞比容持续上升。这些相互矛盾的观察结果促使我们在麻醉大鼠(C组,对照大鼠,n = 10;E组,内毒素大鼠,n = 10)中设计了一项研究,我们在体外循环中连续测量血液中的血细胞比容(传导性细胞)以及125I-人血清白蛋白(HSA)和51Cr标记红细胞(51Cr-RBC;多通道分析仪)浓度的变化。在另外两组实验中,我们测量了血样中蛋白质浓度的变化(系列II,C组:n = 7,E组:n = 7)以及腹腔注射的125I-HSA和51Cr-RBC的摄取情况(反映淋巴流速;系列III,C组:n = 6,E组:n = 7)。通过从t = 0至t = 60分钟静脉输注(iv,0.2 ml/100 g·hr)大肠杆菌内毒素(20 mg/kg)诱导内毒素血症;对照组接受生理盐水。实验在t = 120(系列I和II)或150分钟(系列III)结束。内毒素血症导致血清乳酸显著升高(在t = 120时约升高500%);心率增加而中心静脉压降低(在t = 120时分别约降低20%和95%)。所有大鼠在内毒素血症期间血细胞比容均出现特征性变化:从t = 20至t = 45时增加(约9%),随后在t = 120时降至休克前值或更低。每微升血细胞中的51Cr活性未发生变化,表明没有红细胞动员。蛋白质浓度和125I-HSA活性在内毒素血症期间也出现暂时升高,但每克蛋白质的125I-HSA活性降低。内毒素血症期间腹腔对125I-HSA和51Cr-RBC的摄取显著增加(200%)。我们得出结论,内毒素血症期间的液体外渗是暂时的,主要涉及血浆水,并通过重吸收和淋巴流量增加等机制得到补偿,从而导致血浆容量恢复。