Schmand J F, Ayala A, Morrison M H, Chaudry I H
Department of Surgery, Michigan State University, East Lansing 48824-1315.
J Crit Care. 1994 Dec;9(4):244-54. doi: 10.1016/0883-9441(94)90004-3.
Although the effects of the colloid dextran 70 on induction of anaphylactoid reactions or reticuloendothelial phagocytosis have been examined previously, its effects on specific cell-mediated immunity after trauma-hemorrhage shock remain unknown.
Nonheparinized C3H/HeN mice underwent a laparotomy, were bled, and then maintained at a blood pressure of 35 mm Hg for 60 minutes. Then they were resuscitated with either 4 x the shed blood volume as lactated Ringer's solution (LRS) or 2 x LRS + 1 x dextran 70. Control mice underwent all operative protocols but were neither hemorrhaged, nor resuscitated. At 2 or 24 hours posthemorrhage, serum, splenocytes (SPL), and peritoneal macrophages (pM phi, splenic Mo (sM phi) were obtained. Bioassays were used to determine interleukin-2 (IL-2), IL-3, IL-6, and SPL proliferation.
Trauma-hemorrhage markedly depressed lymphokine release, splenocyte proliferation, and IL-6 release at 2 hours after the insult. The combination of LRS + dextran did not restore lymphocyte functions, but also did not further suppress them. The release of IL-6 by pM phi and sM phi at 2 and 24 hours after dextran infusion and serum IL-6 remained at the same level as in LRS-treated animals.
The combination of LRS and colloid dextran 70 does not adversely affect ex vivo cell-mediated immune functions during the first 24 hours after its administration after trauma-hemorrhage. Thus, from the immunological standpoint, dextran is a safe resuscitation adjunct.
尽管先前已研究了胶体右旋糖酐70对类过敏反应诱导或网状内皮吞噬作用的影响，但其对创伤性失血性休克后特异性细胞介导免疫的影响仍不清楚。
未肝素化的C3H/HeN小鼠接受剖腹手术，放血，然后维持血压35 mmHg 60分钟。然后用4倍失血量的乳酸林格氏液（LRS）或2倍LRS + 1倍右旋糖酐70进行复苏。对照小鼠接受所有手术操作，但既不出血也不复苏。在出血后2或24小时，获取血清、脾细胞（SPL）和腹腔巨噬细胞（pM phi，脾单核细胞（sM phi））。采用生物测定法测定白细胞介素-2（IL-2）、IL-3、IL-6和脾细胞增殖。
创伤性出血在损伤后2小时显著抑制淋巴因子释放、脾细胞增殖和IL-6释放。LRS + 右旋糖酐的组合未恢复淋巴细胞功能，但也未进一步抑制它们。右旋糖酐输注后2和24小时pM phi和sM phi释放的IL-6以及血清IL-6与LRS处理的动物保持在同一水平。
LRS和胶体右旋糖酐70的组合在创伤性出血后给药后的最初24小时内不会对离体细胞介导的免疫功能产生不利影响。因此，从免疫学角度来看，右旋糖酐是一种安全的复苏辅助剂。
