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[公牛肺脏多价蛋白酶抑制剂对烧伤休克和急性烧伤毒血症激肽系统状态的影响]

[Effect of a polyvalent proteinase inhibitor from the lungs of a bull on the state of the kinin system in burn shock and acute burn toxemia].

作者信息

Paskhina T S, Dolgina M I, Nartikova V F, Krinskaia A V, Morozova N A

出版信息

Vopr Med Khim. 1977 Sep-Oct;23(5):689-700.

PMID:339532
Abstract

Effect of a polyvalent inhibitor of proteinases from bovine lungs (industrial preparation -- ingitrile, commercial grade -- conntrical) on the state of kinin system was studied in blood serum of patients with extensive burns at shock periods and in acute burn toxemia. Decrease in content of kallikreinogene, which is typical for shock and acute, toxemia and which reflects the activation of kallikrein-kinin system, was less distinct in patients, treated with the inhibitor, than in patients, which were not treated with ingitrile. The early and rapid restoration in kininogene content and distinct inhibition of the total arginine-esterase activity were observed in blood serum after treatment with the inhibitor. The inhibitor did not affect the phase alterations in the carboxypeptidase N activity within the first 3 days after the burns; the distinct decrease in the enzymatic activity was confirmed within the first period of the burn shock. Within 24-48 hrs after the burns content of alpha1-antitrypsin was distinctly increased in patients treated with ingitrile as compared with the untreated group. The data obtained suggest that the polyvalent proteinase inhibitor causes a decrease in activity of the kallikreinkinin system in blood plasma and affects the enzymes participating indirectly in formation of kinins in burned patients. The data obtained are in agreement with the distinct clinical effect of the inhibitor. The doses of the inhibitor used in these studies did not cause normalizing effect on the activity of the kinin system components and on the clinical state of patients only in extremely severe cases of burn shock and in acute burn toxemia with letal outcome within the few days after the injury.

摘要

研究了牛肺蛋白酶多价抑制剂(工业制剂——英腈,商业级——康特里卡尔)对大面积烧伤患者休克期血清及急性烧伤毒血症患者激肽系统状态的影响。激肽释放酶原含量降低是休克和急性毒血症的典型表现,反映了激肽释放酶-激肽系统的激活,在接受抑制剂治疗的患者中,这种降低不如未接受英腈治疗的患者明显。用抑制剂治疗后,血清中激肽原含量早期迅速恢复,总精氨酸酯酶活性明显受到抑制。在烧伤后的头3天内,抑制剂对羧肽酶N活性的阶段性变化没有影响;在烧伤休克的第一阶段,酶活性明显降低得到证实。与未治疗组相比,在烧伤后24 - 48小时内,接受英腈治疗的患者α1-抗胰蛋白酶含量明显增加。所获得的数据表明,多价蛋白酶抑制剂可使血浆中激肽释放酶-激肽系统的活性降低,并影响烧伤患者中间接参与激肽形成的酶。所获得的数据与抑制剂明显的临床效果一致。在这些研究中使用的抑制剂剂量,仅在极其严重的烧伤休克病例以及伤后数天内出现致命结局的急性烧伤毒血症病例中,才对激肽系统成分的活性和患者的临床状态没有产生正常化作用。

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