Yurt R W, Pruitt B A
Surgery. 1985 Aug;98(2):191-8.
To assess the pathogenesis of increased susceptibility to infection and septic death in a rat model, neutrophils (PMNs) in the wound, circulating PMNs, and their in vivo activity were evaluated after 30% and 60% burns. Eight hours after injury there were twice as many PMNs in the wounds of rats that sustained 30% compared with 60% burns. There was no difference between these two groups in the number of circulating PMNs at 2, 4, 6, and 8 hours after injury. In vivo evaluation of PMN response to infusion of F-Met-Leu-Phe revealed that circulating PMNs were more sensitive 4 hours after 60% burns compared with sham burns. At this time PMNs were found to be less sensitive to zymosan-activated serum infusion after 30% burns compared with sham burns. However, the PMNs in rats with 30% burns were more sensitive to this stimulus than were PMNs in rats with 60% injuries. Thus rats with greater injury, known to be more susceptible to wound infection, have fewer PMNs in their wounds 8 hours after injury. This is preceded by an increased sensitivity of PMNs in vivo to bacterial chemotactic factor and a relative increase in sensitivity to wound factors. This unusual finding implicates indiscrete margination as a factor in the pathogenesis of infection.
为评估大鼠模型中感染易感性增加及脓毒症死亡的发病机制，在30%和60%烧伤后，对伤口中的中性粒细胞（PMN）、循环中的PMN及其体内活性进行了评估。受伤8小时后，30%烧伤大鼠伤口中的PMN数量是60%烧伤大鼠的两倍。在受伤后2、4、6和8小时，这两组循环中的PMN数量没有差异。对PMN对F-Met-Leu-Phe输注反应的体内评估显示，与假烧伤相比，60%烧伤后4小时循环中的PMN更敏感。此时，与假烧伤相比，30%烧伤后PMN对酵母聚糖激活血清输注的敏感性较低。然而，30%烧伤大鼠的PMN对这种刺激比60%损伤大鼠的PMN更敏感。因此，已知更易发生伤口感染的严重损伤大鼠在受伤8小时后伤口中的PMN较少。在此之前，PMN在体内对细菌趋化因子的敏感性增加，对伤口因子的敏感性相对增加。这一不同寻常的发现表明，不连续的边缘化是感染发病机制中的一个因素。
