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别嘌醇和洛度沙胺在补体诱导的肝缺血中的作用

Allopurinol and lodoxamide in complement-induced hepatic ischemia.

作者信息

Schirmer W J, Schirmer J M, Naff G B, Fry D E

机构信息

Department of Surgery, Veterans Administration Medical Center, Case Western Reserve University Hospitals, Cleveland, Ohio 44106.

出版信息

J Surg Res. 1988 Jul;45(1):28-36. doi: 10.1016/0022-4804(88)90017-0.

DOI:10.1016/0022-4804(88)90017-0
PMID:3260642
Abstract

Intravascular complement activation with either zymosan or cobra venom factor (CVF) impairs hepatic blood flow. Oxygen radical scavengers given at the time of complement activation attenuate the resulting hepatic ischemia. It is not clear whether complement-stimulated phagocytes or transiently ischemic then reperfused endothelial and parenchymal cells generated the toxic oxygen radicals. In this study, a group of rats were given allopurinol (50 mg/kg/day postoperatively X 3 days plus 100 mg/kg iv at t = 0), a specific inhibitor of xanthine oxidase, prior to complement activation with CVF (20 units/kg iv at t = 30 and 60 min) to determine whether xanthine oxidase-derived oxygen radicals contributed significantly to the hepatic perfusion abnormalities. Additional rats received lodoxamide tromethamine (10 mg/kg iv bolus at t = 0 followed by 20 mg/kg/hr iv infusion), a novel and potent inhibitor of mast cell release and inhibitor of xanthine oxidase, prior to the same CVF challenge to determine whether mast cell mediators were involved in the flow disturbance. Thermodilution cardiac output, mean arterial pressure, heart rate, hematocrit, and effective hepatic blood flow (EHBF) by galactose clearance were determined at t = 2 hr. The percentage change in total hemolytic complement activity (% delta CH50) was determined between serum obtained prior to sacrifice and at t = 0. Systemic hemodynamics and HCT were for the most part unaffected regardless of pretreatment group or challenge with CVF or saline. CVF challenge produced a 25% reduction (P less than 0.05) in EHBF in vehicle-pretreated rats compared to saline challenge. Neither allopurinol nor lodoxamide tromethamine significantly improved EHBF when given prior to CVF challenge.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

用酵母聚糖或眼镜蛇毒因子(CVF)激活血管内补体可损害肝血流。在补体激活时给予氧自由基清除剂可减轻由此产生的肝缺血。尚不清楚是补体刺激的吞噬细胞还是短暂缺血后再灌注的内皮细胞和实质细胞产生了有毒的氧自由基。在本研究中,一组大鼠在经CVF(在t = 30和60分钟时静脉注射20单位/千克)激活补体之前,给予黄嘌呤氧化酶的特异性抑制剂别嘌呤醇(术后50毫克/千克/天×3天,加上在t = 0时静脉注射100毫克/千克),以确定黄嘌呤氧化酶衍生的氧自由基是否对肝灌注异常有显著影响。另外的大鼠在相同的CVF刺激之前,接受洛度沙胺 tromethamine(在t = 0时静脉推注10毫克/千克,随后以20毫克/千克/小时静脉输注),一种新型强效的肥大细胞释放抑制剂和黄嘌呤氧化酶抑制剂,以确定肥大细胞介质是否参与血流紊乱。在t = 2小时时,通过热稀释法测定心输出量、平均动脉压、心率、血细胞比容,并通过半乳糖清除率测定有效肝血流量(EHBF)。在处死前和t = 0时获得的血清之间测定总溶血补体活性的百分比变化(%δCH50)。无论预处理组如何,也无论是否用CVF或生理盐水刺激,全身血流动力学和血细胞比容在很大程度上均未受影响。与生理盐水刺激相比,CVF刺激使溶媒预处理的大鼠的EHBF降低了25%(P < 0.05)。在CVF刺激之前给予别嘌呤醇或洛度沙胺tromethamine均未显著改善EHBF。(摘要截断于250字)

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