Livingston C D, Levine B A, Sirinek K R
J Surg Res. 1983 Apr;34(4):332-6. doi: 10.1016/0022-4804(83)90080-x.
Prophylactic penicillin, splenic autotransplantation, and immunization using pneumococcal vaccine have all been shown to reduce the incidence and mortality of postsplenectomy sepsis. However, little is known regarding the effect of penicillin in established infection or the effect of prior infection in either asplenic controls or animals with autotransplanted splenic tissue. An animal model with bacterial introduction via the lungs was used to investigate the effect of penicillin, splenic autotransplantation, and previous exposure to the infecting organism on the mortality of postsplenectomy sepsis. One hundred fifty-nine rats underwent either sham celiotomy, intraperitoneal splenic autotransplantation, or splenectomy. Twelve weeks postoperatively all animals were challenged using Streptococcus pneumoniae delivered transtracheally. Half of each group received procaine penicillin by intramuscular injection for 5 days beginning 24 hr post bacterial inoculation and mortality was observed. Eight weeks later surviving rats that had received penicillin were reinoculated with the same organism and mortality was again observed. Splenic autotransplantation reduced the early mortality in postsplenectomy sepsis. Prior bacterial exposure reduced the mortality in postsplenectomy sepsis, even in splenectomized animals. Treatment with penicillin produced a marked reduction in mortality even when administration was postponed for 24 hr after bacterial inoculation.
预防性使用青霉素、脾自体移植以及接种肺炎球菌疫苗均已被证明可降低脾切除术后败血症的发病率和死亡率。然而，关于青霉素在已确诊感染中的作用，以及既往感染在无脾对照动物或脾组织自体移植动物中的影响，人们了解甚少。采用经肺部引入细菌的动物模型，来研究青霉素、脾自体移植以及既往接触感染病原体对脾切除术后败血症死亡率的影响。159只大鼠分别接受假剖腹术、腹腔内脾自体移植或脾切除术。术后12周，所有动物经气管内注入肺炎链球菌进行攻击。每组动物的一半在细菌接种后24小时开始，通过肌肉注射给予普鲁卡因青霉素，持续5天，并观察死亡率。8周后，对之前接受过青霉素治疗的存活大鼠再次接种相同病原体，并再次观察死亡率。脾自体移植降低了脾切除术后败血症的早期死亡率。即使是在脾切除的动物中，既往接触细菌也降低了脾切除术后败血症的死亡率。即使在细菌接种后24小时才开始使用青霉素治疗，也能显著降低死亡率。
