Endo S, Inada K, Yamada Y, Takakuwa T, Kasai T, Nakae H, Yoshida M, Ceska M
Critical Care and Emergency Center, Iwate Medical University, Morioka, Japan.
Crit Care Med. 1994 Jun;22(6):949-55. doi: 10.1097/00003246-199406000-00012.
The roles of cytokines and endotoxin in hemorrhagic shock, particularly the translocation of endotoxin and bacteria during hemorrhagic shock, were investigated.
Prospective study.
Critical care and emergency center of a university hospital.
Twenty-nine patients with hemorrhagic shock and 20 healthy controls.
Serial blood samples were collected from both study and control patients. Standard resuscitation techniques were used.
Plasma levels of endotoxin and various cytokines were determined repeatedly during hemorrhagic shock. Endotoxin was measured using an endotoxin-specific assay in addition to a new perchloric acid method for pretreatment of plasma. Cytokines were measured by commercial enzyme-linked immunosorbent assays. Plasma endotoxin concentrations remained within the normal range for 7 days after admission. Although levels of tumor necrosis factor-alpha and several interleukins increased slightly in some patients, these cytokines did not reach the levels seen in septic shock.
Translocation of bacteria or endotoxin from the gastrointestinal tract into the bloodstream has been noted in animal experiments; however, translocation was not detected in our patients with hemorrhagic shock.
研究细胞因子和内毒素在失血性休克中的作用，尤其是失血性休克期间内毒素和细菌的移位情况。
前瞻性研究。
一所大学医院的重症监护和急救中心。
29例失血性休克患者和20名健康对照者。
从研究患者和对照患者中采集系列血样。采用标准复苏技术。
在失血性休克期间反复测定血浆内毒素和多种细胞因子水平。除了一种用于血浆预处理的新的高氯酸方法外，还使用内毒素特异性检测法测量内毒素。细胞因子通过商业酶联免疫吸附测定法测量。入院后7天血浆内毒素浓度维持在正常范围内。虽然部分患者肿瘤坏死因子-α和几种白细胞介素水平略有升高，但这些细胞因子未达到脓毒性休克时的水平。
在动物实验中已注意到细菌或内毒素从胃肠道移位至血流；然而，在我们的失血性休克患者中未检测到移位情况。
