Johnson K M, Garcia R M, Heitkemper M, Helton W S
Department of Surgery, University of Washington, Seattle, USA.
Arch Surg. 1995 Dec;130(12):1294-9; discussion 1299-300. doi: 10.1001/archsurg.1995.01430120048007.
To determine the effects of polymyxin B sulfate in rats fed by total parenteral nutrition on norepinephrine excretion, macrophage tumor necrosis factor production, and bacterial translocation.
Randomized animal study.
A university teaching hospital in Seattle, Wash.
Three groups of rats were studied: chow plus intravenous saline, total parenteral nutrition, or total parenteral nutrition supplemented with polymyxin B sulfate. After 5 days, urinary excretion of norepinephrine and epinephrine was calculated, peritoneal and alveolar macrophages were cultured, and their spontaneous and lipopolysaccharide-stimulated tumor necrosis factor production was measured. Mesenteric lymph nodes were cultured for bacteria.
Rats fed by total parenteral nutrition had increased urine norepinephrine excretion (33%) and alveolar macrophage tumor necrosis factor production (80%) and trends for increased epinephrine excretion and bacterial translocation compared with rats fed chow. Alveolar but not peritoneal macrophage tumor necrosis factor production was significantly related to norepinephrine excretion (r = .5, P < .01). The addition of polymyxin B to total parenteral nutrition decreased weight gain (P < .05), urinary norepinephrine excretion (P < .01), and alveolar macrophage tumor necrosis factor production (P < .05) compared with rats fed by total parenteral nutrition. Polymyxin B also tended to decrease the magnitude of bacterial translocation.
Alveolar macrophage tumor necrosis factor production appears to be influenced by sympathetic nervous activity. Total parenteral nutrition-induced endotoxemia may indirectly alter macrophage function by stimulating sympathetic nervous activity.
确定硫酸多粘菌素B对接受全胃肠外营养的大鼠去甲肾上腺素排泄、巨噬细胞肿瘤坏死因子生成及细菌移位的影响。
随机动物研究。
华盛顿州西雅图的一家大学教学医院。
研究三组大鼠：正常饮食加静脉输注生理盐水组、全胃肠外营养组、全胃肠外营养补充硫酸多粘菌素B组。5天后，计算去甲肾上腺素和肾上腺素的尿排泄量，培养腹膜和肺泡巨噬细胞，并测量其自发和脂多糖刺激的肿瘤坏死因子生成量。培养肠系膜淋巴结以检测细菌。
与正常饮食喂养的大鼠相比，接受全胃肠外营养的大鼠尿去甲肾上腺素排泄量增加（33%），肺泡巨噬细胞肿瘤坏死因子生成量增加（80%），肾上腺素排泄量及细菌移位有增加趋势。肺泡而非腹膜巨噬细胞肿瘤坏死因子生成量与去甲肾上腺素排泄量显著相关（r = 0.5，P < 0.01）。与接受全胃肠外营养的大鼠相比，在全胃肠外营养中添加硫酸多粘菌素B可使体重增加减少（P < 0.05）、尿去甲肾上腺素排泄量减少（P < 0.01）、肺泡巨噬细胞肿瘤坏死因子生成量减少（P < 0.05）。硫酸多粘菌素B也有降低细菌移位程度的趋势。
肺泡巨噬细胞肿瘤坏死因子生成似乎受交感神经活动影响。全胃肠外营养诱导的内毒素血症可能通过刺激交感神经活动间接改变巨噬细胞功能。
