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肝素对手术创伤后血源微粒清除及分布的影响

Heparin induced alterations in clearance and distribution of blood-borne microparticles following operative trauma.

作者信息

Saba T M, Antikatzides T G

出版信息

Ann Surg. 1979 Apr;189(4):426-32.

Abstract

The influence of systemic heparin administration on the vascular clearance and tissue distribution of blood-borne microparticles was evaluated in normal rats and rats after operation (laparotomy plus intestinal manipulation) utilizing an (131)I- colloid which is phagocytized by the reticuloendothelial system (RES). Intravenous heparin administration (100 USP/100g body weight) into normal animals three minutes prior to colloid injection (50 mg/lOOg) induced a significant increase in pulmonary localization of the microparticles as compared to nonheparinized control rats, while hepatic and splenic uptake were decreased. Surgical trauma decreased hepatic RE uptake and increased pulmonary localization of the microparticles when injected systemically at 60 minutes postsurgery. Heparin administration 60 minutes after surgery and three minutes prior to colloid injection, magnified the increased pulmonary localization response with an associated further depression of the RES. The ability of heparin to alter both RE clearance function and lung localization of microparticles was dose dependent and a function of the interval between heparin administration and systemic particulate infusion. Thus, low dose heparin administration was capable of stimulating RE activity while heparin in doses of excess of 50 USP units/lOOg body weight decreased RE function. These findings suggest that the functional state of the hepatic RE system can be greatly affected in a dose-dependent manner by systemic heparin administration which may influence distribution of blood-borne microparticles.

摘要

利用被网状内皮系统(RES)吞噬的(131)I - 胶体,在正常大鼠和术后(剖腹术加肠道操作)大鼠中评估了全身给予肝素对血源性微粒的血管清除和组织分布的影响。在胶体注射(50mg/100g)前3分钟向正常动物静脉注射肝素(100 USP/100g体重),与未用肝素处理的对照大鼠相比,微粒在肺部的定位显著增加,而肝脏和脾脏的摄取减少。术后60分钟全身注射时,手术创伤降低了肝脏RES摄取并增加了微粒在肺部的定位。术后60分钟且在胶体注射前3分钟给予肝素,放大了肺部定位增加的反应,并伴有RES的进一步抑制。肝素改变RES清除功能和微粒肺部定位的能力是剂量依赖性的,并且是肝素给药与全身微粒输注之间间隔时间的函数。因此,低剂量肝素给药能够刺激RES活性,而超过50 USP单位/100g体重的肝素剂量会降低RES功能。这些发现表明,全身给予肝素可通过剂量依赖性方式极大地影响肝脏RES系统的功能状态,这可能会影响血源性微粒的分布。

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