Schirmer W J, Schirmer J M, Townsend M C, Fry D E
Circ Shock. 1987;21(4):253-9.
Visceral microcirculatory insufficiency has been demonstrated in sepsis despite a hyperdynamic systemic circulation. This study examines the effect of the cyclo-oxygenase inhibitor indomethacin and the thromboxane synthetase inhibitor imidazole on septic hemodynamics and visceral perfusion in a septic rat model of cecal ligation and puncture. Animals received either indomethacin (INDO), imidazole (IMID), or saline intramuscularly at t = 0, 6, and 12 hr of peritonitis. Thermodilution cardiac output, mean arterial pressure, heart rate, hematocrit, effective hepatic blood flow, effective renal plasma flow, and arterial and mixed venous blood gases were determined at 15 hr. Both INDO and IMID improved effective hepatic blood flow in the septic animals to virtually sham, nonseptic levels without significantly altering systemic hemodynamics. This study suggests that the reduction in hepatic perfusion in sepsis may be mediated by thromboxane, the synthesis of which is suppressed by both INDO and IMID.
尽管全身循环处于高动力状态，但在脓毒症中已证实存在内脏微循环功能不全。本研究在盲肠结扎和穿刺的脓毒症大鼠模型中，研究环氧化酶抑制剂吲哚美辛和血栓素合成酶抑制剂咪唑对脓毒症血流动力学和内脏灌注的影响。在腹膜炎发生后的0、6和12小时，动物分别接受吲哚美辛（INDO）、咪唑（IMID）或生理盐水肌肉注射。在15小时时测定热稀释心输出量、平均动脉压、心率、血细胞比容、有效肝血流量、有效肾血浆流量以及动脉血和混合静脉血气。INDO和IMID均可将脓毒症动物的有效肝血流量改善至几乎与假手术、非脓毒症动物相同的水平，且未显著改变全身血流动力学。本研究表明，脓毒症中肝灌注的降低可能由血栓素介导，而INDO和IMID均可抑制血栓素的合成。
