Evans D A, Jacobs D O, Rounds J, Wilmore D W
Department of Surgery, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts 02115.
J Surg Res. 1993 Jan;54(1):39-45. doi: 10.1006/jsre.1993.1007.
Tumor necrosis factor (TNF) is thought to be an important mediator of the septic response; intravenous administration of this cytokine provokes a wide range of metabolic and hemodynamic effects which closely resemble those known to follow endotoxin administration. These effects include damage to gut mucosa. Since the gut constitutes an internal reservoir of endotoxin and bacteria it is possible that some of TNF's effects might be secondary to an increased absorption of these agents. To test this hypothesis TNF was given both to intact dogs and also to animals in which the gut had been removed, from duodenum to anus ("enterectomy"). The data indicates that the effects of TNF upon systemic pressure, white count, and cortisol and glucagon levels were not affected by prior removal of the gut. For most other parameters the findings were less clear but in general the changes in enterectomized dogs were qualitatively similar to those described in the intact animal. We conclude that the effects observed following TNF infusion in the dog are not dependent on the intestinal tract as a secondary source of bacteria or mediators.
肿瘤坏死因子（TNF）被认为是脓毒症反应的重要介质；静脉注射这种细胞因子会引发一系列代谢和血流动力学效应，这些效应与已知的内毒素注射后的效应非常相似。这些效应包括对肠黏膜的损伤。由于肠道是内毒素和细菌的内部储存库，因此TNF的某些效应可能继发于这些物质吸收的增加。为了验证这一假设，将TNF分别给予完整的狗以及肠道已从十二指肠至肛门切除（“肠切除术”）的动物。数据表明，TNF对全身血压、白细胞计数以及皮质醇和胰高血糖素水平的影响不受预先切除肠道的影响。对于大多数其他参数，结果不太明确，但总体而言，肠切除狗的变化在性质上与完整动物中描述的变化相似。我们得出结论，在狗身上注入TNF后观察到的效应并不依赖于肠道作为细菌或介质的次要来源。
