Toft P, Helbo-Hansen H S, Tønnesen E, Lillevang S T, Rasmussen J W, Christensen N J
Department of Anaesthesiology and Intensive Care, Odense University Hospital, Denmark.
Acta Anaesthesiol Scand. 1994 Apr;38(3):254-8. doi: 10.1111/j.1399-6576.1994.tb03884.x.
Major surgical procedures induce an endocrine metabolic stress response characterized by increased secretion of adrenaline and cortisol. Furthermore, surgical stress is accompanied by granulocytosis in peripheral blood. The granulocytosis may be due to increased adrenaline and cortisol secretion. The purpose of this study was to investigate the redistribution of granulocytes during adrenaline infusion and following administration of cortisol. Granulocytes were isolated from peripheral blood from eight healthy volunteers, labelled with indium-111-tropolene and reinjected. The distribution of granulocytes was imaged by using a gamma camera and calculated with an interfaced computer three times during a control period and three times during a corresponding hour af adrenaline infusion 0.05 micrograms kg b.w.-1 min-1. The distribution was then measured every second h for another 6-h control period and then for 6 h following administration of cortisol 3.6 mg kg b.w.-1. Infusion of adrenaline resulted in granulocytosis in peripheral blood and a reduction of radioactivity of the spleen to 83.0% of the initial value. The effect of adrenaline on the bone marrow was negligible. Cortisol administration was followed by granulocytosis and decreased radioactivity of both the spleen (81.5%) and the bone marrow (79.8%). It is concluded that the spleen is an active immunological organ as both adrenaline and cortisol induces efflux of granulocytes from the spleen. The cortisol induced efflux of granulocytes from the bone marrow explains that granulocytosis also occurs in splenectomized patients after major surgery.
大型外科手术会引发一种内分泌代谢应激反应，其特征为肾上腺素和皮质醇分泌增加。此外，手术应激还伴有外周血粒细胞增多。粒细胞增多可能是由于肾上腺素和皮质醇分泌增加所致。本研究的目的是调查肾上腺素输注期间及皮质醇给药后粒细胞的重新分布情况。从八名健康志愿者的外周血中分离出粒细胞，用铟 - 111 - 托品酮标记后重新注入。在对照期使用γ相机对粒细胞分布进行成像，并通过接口计算机计算三次，在肾上腺素以0.05微克/千克体重 - 1·分钟 - 1输注的相应小时内也计算三次。然后在另外6小时的对照期内每两小时测量一次分布情况，之后在给予3.6毫克/千克体重 - 1的皮质醇后再测量6小时。肾上腺素输注导致外周血粒细胞增多，脾脏放射性降至初始值的83.0%。肾上腺素对骨髓的影响可忽略不计。给予皮质醇后出现粒细胞增多，脾脏（81.5%）和骨髓（79.8%）的放射性均降低。得出的结论是，脾脏是一个活跃的免疫器官，因为肾上腺素和皮质醇都会诱导粒细胞从脾脏流出。皮质醇诱导粒细胞从骨髓流出解释了在大型手术后脾切除患者中也会出现粒细胞增多的现象。
