Clements W D, Halliday M I, McCaigue M D, Barclay R G, Rowlands B J
Department of Surgery, Queen's University of Belfast, Northern Ireland.
Arch Surg. 1993 Feb;128(2):200-4; discussion 204-5. doi: 10.1001/archsurg.1993.01420140077012.
Systemic endotoxemia consistently occurs in jaundiced patients undergoing surgery. Kupffer cell dysfunction is implicated in the development of endotoxemia and its postoperative complications. A novel in situ single-pass hepatic perfusion technique using a fluorescein isothiocyanate-labeled latex probe was developed for measuring Kupffer cell clearance capacity and was applied in an animal model of biliary obstruction. Control rats and rats jaundiced for 1, 2, 3, and 4 weeks' duration were studied. Kupffer cell clearance capacity, plasma bilirubin, endotoxin, and anticore glycolipid concentrations were measured. Maximal hyperbilirubinemia preceded reduced Kupffer cell clearance capacity. Rats jaundiced for greater than 2 weeks had a significantly decreased Kupffer cell clearance capacity but significantly higher endotoxin and anticore glycolipid concentrations. Anticore glycolipid concentrations correlated strongly with systemic endotoxemia and both were inversely correlated with duration of jaundice. Impairment of Kupffer cell clearance capacity may contribute to endotoxemia associated with cholestasis.
接受手术的黄疸患者常出现全身性内毒素血症。库普弗细胞功能障碍与内毒素血症及其术后并发症的发生有关。一种使用异硫氰酸荧光素标记乳胶探针的新型原位单通道肝脏灌注技术被开发用于测量库普弗细胞清除能力，并应用于胆道梗阻动物模型。研究了对照大鼠以及黄疸持续1、2、3和4周的大鼠。测量了库普弗细胞清除能力、血浆胆红素、内毒素和抗核心糖脂浓度。最大高胆红素血症先于库普弗细胞清除能力降低出现。黄疸超过2周的大鼠库普弗细胞清除能力显著降低，但内毒素和抗核心糖脂浓度显著升高。抗核心糖脂浓度与全身性内毒素血症密切相关，且二者均与黄疸持续时间呈负相关。库普弗细胞清除能力受损可能导致与胆汁淤积相关的内毒素血症。
