Cone J B, Wallace B H, Lubansky H J, Caldwell F T
University of Arkansas for Medical Sciences, Department of Surgery, Little Rock 72205, USA.
J Trauma. 1997 Jul;43(1):41-5; discussion 45-6. doi: 10.1097/00005373-199707000-00011.
Burn injury is characterized by hypermetabolism and protein catabolism. Endotoxin, derived from either wound or gut, may participate in this response.
Eleven seriously burned patients were treated with the endotoxin-binding agent polymyxin B and underwent partitional calorimetry and nitrogen balance studies. The data from theses patients were compared with data from 28 contemporary, similarly burned patients who did not receive polymyxin B.
Elevated levels of circulating endotoxin were not consistently detected in either group. Interleukin-6 was elevated and correlated with rectal temperature and nitrogen excretion in both groups. Administration of polymyxin B produced no change in metabolic rate but produced a significantly more positive nitrogen balance and was associated with a prompt reduction in interleukin-6 levels.
These data support the hypothesis that endotoxin plays a role in the postburn protein catabolism but not in the hypermetabolic response. This protein catabolic response is statistically associated with circulating interleukin-6 levels, suggesting a possible role for interleukin-6 in postinjury protein wasting.
烧伤的特点是高代谢和蛋白质分解代谢。来自伤口或肠道的内毒素可能参与这种反应。
11名严重烧伤患者接受了内毒素结合剂多粘菌素B治疗，并进行了间接测热法和氮平衡研究。将这些患者的数据与28名未接受多粘菌素B治疗的当代类似烧伤患者的数据进行比较。
两组均未持续检测到循环内毒素水平升高。两组白细胞介素-6均升高，且与直肠温度和氮排泄相关。给予多粘菌素B后代谢率无变化，但氮平衡明显更正向，且与白细胞介素-6水平迅速降低有关。
这些数据支持以下假设，即内毒素在烧伤后蛋白质分解代谢中起作用，但在高代谢反应中不起作用。这种蛋白质分解代谢反应与循环白细胞介素-6水平在统计学上相关，提示白细胞介素-6在损伤后蛋白质消耗中可能起作用。
