Hurewitz A N, Lidonicci K, Wu C L, Reim D, Zucker S
Department of Medicine, SUNY at Stony Brook.
Chest. 1994 Oct;106(4):1241-5. doi: 10.1378/chest.106.4.1241.
The effects of doxycycline hyclate (DOXY) pleurodesis were compared with those of tetracycline hydrochloride (TCN) in 25 healthy New Zealand White rabbits. One group of rabbits received TCN (pH 2.0) in the left pleural space at a concentration of 35 mg/kg in 3.0 ml of saline solution. Four other groups of rabbits received DOXY in two concentrations (35 mg/kg or 10 mg/kg) and at two pHs (an acid of 2.0 and a NaOH neutralized pH of 7.6). No attempt was made to drain the pleural space after pleurodesis. At autopsy 2 weeks later, bloody fluid filled the pleural cavity and extensive intrapleural adhesions compressed the underlying lung. Microscopically, fibrin and collagen were diffusely deposited in the pleural connective tissue and in the intrapleural adhesions. The visceral pleural thickness increased from its normal value of 0.01 mm to values of 0.5 to 0.9 mm in the TCN and DOXY groups. Fibroblasts were the predominant inflammatory cell in the pleural connective tissue with few neutrophils or lymphocytes. No significant differences of histologic characteristics were observed between the TCN and DOXY groups. Alterations in pH or concentration in the DOXY groups produced similar changes in the gross and microscopic appearance of the pleural space. We conclude that DOXY is as effective as TCN in producing chemical pleurodesis. Doxycycline concentrations of 10 mg/kg were sufficient to substantially sclerose the pleural space in these healthy rabbits. Doxycycline pleurodesis was effective at neutral pH suggesting a mechanism of action independent of acid injury to the mesothelium.
在25只健康的新西兰白兔中，比较了盐酸多西环素（DOXY）胸膜固定术与盐酸四环素（TCN）胸膜固定术的效果。一组兔子在左侧胸腔内注射pH值为2.0的TCN，浓度为35mg/kg，溶于3.0ml盐溶液中。另外四组兔子分别接受两种浓度（35mg/kg或10mg/kg）和两种pH值（酸性pH值2.0和用氢氧化钠中和后的pH值7.6）的DOXY。胸膜固定术后未尝试引流胸腔。两周后尸检发现，血性液体充满胸腔，广泛的胸膜内粘连压迫下方的肺组织。显微镜下，纤维蛋白和胶原蛋白弥漫性沉积于胸膜结缔组织和胸膜内粘连处。TCN组和DOXY组的脏层胸膜厚度从正常的0.01mm增加到0.5至0.9mm。成纤维细胞是胸膜结缔组织中主要的炎性细胞，中性粒细胞或淋巴细胞较少。TCN组和DOXY组之间未观察到组织学特征的显著差异。DOXY组中pH值或浓度的改变在胸腔的大体和显微镜外观上产生了相似的变化。我们得出结论，DOXY在产生化学性胸膜固定方面与TCN一样有效。10mg/kg的多西环素浓度足以使这些健康兔子的胸腔充分硬化。多西环素胸膜固定术在中性pH值时有效，提示其作用机制独立于对间皮的酸损伤。
