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兔腹腔内注射内毒素后的全身和局部血流动力学变化:一种新的高动力型脓毒症临床综合征模型的建立

Systemic and regional hemodynamic changes after intraperitoneal endotoxin in rabbits: development of a new model of the clinical syndrome of hyperdynamic sepsis.

作者信息

Fink M P, Fiallo V, Stein K L, Gardiner W M

出版信息

Circ Shock. 1987;22(1):73-81.

PMID:3301051
Abstract

Rabbits were injected intraperitoneally with sterile saline or Escherichia coli endotoxin (LPS; 50 or 500 micrograms/kg). Sixteen to 18 h later, the animals were anesthetized with ketamine and instrumented to permit measurement of mean arterial pressure, cardiac output (by thermodilution), and regional blood flow (using radioactive microspheres). The animals were allowed to waken fully in a plastic restraining cage prior to measuring systemic and regional hemodynamics. LPS had similar effects regardless of dose, and results from the two dosage groups have been combined. Compared to controls, administrations of LPS resulted in a 29.3% increase in cardiac output (P = .011) and a 22.8% decrease in systemic vascular resistance (P = .0009). Injection of LPS caused significant changes in blood flow to the heart (55.3% increase), small intestine (128.3% increase), portal vein (54.7% increase), and hepatic artery (65.0% decrease). The percentage of cardiac output perfusing the kidneys and hepatic artery was significantly decreased in the endotoxemic group (P = .037 and P = .002, respectively). Injecting LPS resulted in increased relative flow to the heart (P = .024), small intestine (P = .049), and portal vein (P = .041). We conclude that this model reproduces several of the systemic hemodynamic features of the sepsis syndrome in humans. In this model, the hyperdynamic state is associated with vasodilatation in mesenteric (small intestine and colon) and coronary beds and vasoconstriction in the hepatic artery.

摘要

给兔子腹腔注射无菌生理盐水或大肠杆菌内毒素(LPS;50或500微克/千克)。16至18小时后,用氯胺酮麻醉动物,并安装仪器以测量平均动脉压、心输出量(通过热稀释法)和局部血流量(使用放射性微球)。在测量全身和局部血流动力学之前,让动物在塑料约束笼中完全苏醒。无论剂量如何,LPS都有相似的作用,两个剂量组的结果已合并。与对照组相比,给予LPS导致心输出量增加29.3%(P = .011),全身血管阻力降低22.8%(P = .0009)。注射LPS导致心脏血流量(增加55.3%)、小肠血流量(增加128.3%)、门静脉血流量(增加54.7%)和肝动脉血流量(减少65.0%)发生显著变化。在内毒素血症组中,灌注肾脏和肝动脉的心输出量百分比显著降低(分别为P = .037和P = .002)。注射LPS导致心脏(P = .024)、小肠(P = .049)和门静脉(P = .041)的相对血流量增加。我们得出结论,该模型再现了人类脓毒症综合征的几种全身血流动力学特征。在该模型中,高动力状态与肠系膜(小肠和结肠)和冠状动脉床的血管舒张以及肝动脉的血管收缩有关。

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