Lundblad R, Giercksky K E
Norwegian Radium Hospital, Oslo.
J Infect Dis. 1995 Jul;172(1):152-60. doi: 10.1093/infdis/172.1.152.
The protective effect of volume support, imipenem, and the anti-endotoxin antibody E5 given as mono- or combination therapy was studied in fulminant intraabdominal sepsis in rats. Mortality, blood levels of bacteria, endotoxin, tumor necrosis factor (TNF), and lactate, and packed cell volume were measured. All monotherapy regimens improved survival, and protection decreased with delayed intervention. Volume support prevented dehydration and lactate accumulation but had no effect on levels of bacteria, endotoxin, or TNF. Imipenem killed bacteria and released endotoxin, and lactacidosis was reduced. E5 reduced endotoxin, TNF, and lactate but not bacteremia. The imipenem-induced increase in plasma endotoxin was abolished by E5. When E5 was added to a regimen of volume support plus imipenem 6 h after induction, it gave an extra improvement of survival, but this synergism disappeared when intervention was delayed 4 h more. The primary effect of E5 was a reduction in plasma endotoxin level.
在大鼠暴发性腹腔内脓毒症中，研究了容量支持、亚胺培南以及抗内毒素抗体E5单一或联合治疗的保护作用。测定了死亡率、血液中的细菌水平、内毒素、肿瘤坏死因子（TNF）和乳酸水平以及血细胞比容。所有单一治疗方案均提高了生存率，且随着干预延迟，保护作用减弱。容量支持可防止脱水和乳酸积累，但对细菌、内毒素或TNF水平无影响。亚胺培南可杀灭细菌并释放内毒素，且可减轻乳酸性酸中毒。E5可降低内毒素、TNF和乳酸水平，但对菌血症无效。E5可消除亚胺培南诱导的血浆内毒素增加。当在诱导后6小时将E5添加到容量支持加亚胺培南的治疗方案中时，可进一步提高生存率，但当干预再延迟4小时时，这种协同作用消失。E5的主要作用是降低血浆内毒素水平。
