Mikawa K, Nishina K, Tamada M, Takao Y, Maekawa N, Obara H
Department of Anaesthesiology, Kobe University School of Medicine, Japan.
Crit Care Med. 1998 May;26(5):905-11. doi: 10.1097/00003246-199805000-00026.
To assess the effect of aminoguanidine, a selective inducible nitric oxide synthase inhibitor, on endotoxin-induced acute lung injury in rabbits.
Prospective, blinded, controlled laboratory study.
University research laboratory.
Twenty-eight male rabbits.
The animals were randomly assigned to receive one of four treatments (n = 7 for each group): infusion of saline only (S-S group), infusion of saline and aminoguanidine (S-AG group), infusion of Escherichia coli endotoxin (5 mg/kg over 60 mins) (E-S group), and infusion of endotoxin and aminoguanidine (E-AG group). Fifteen minutes before infusion of endotoxin (E-S and E-AG groups) or saline (S-S and S-AG groups), the animals received an intravenous injection of 1 mg/kg of aminoguanidine (S-AG and E-AG groups) or saline (S-S and E-S groups). The same dose of aminoguanidine or saline was given 1 hr after the end of endotoxin or saline infusion. The lungs of the rabbits were ventilated with 40% oxygen.
Hemodynamics, peripheral leukocyte counts, and PaO2 were recorded during the ventilation period (6 hrs). After these observations were made, lung mechanics, cell fraction of bronchoalveolar lavage fluid, and concentrations of thromboxane A2 and prostacyclin metabolites in bronchoalveolar lavage fluid were determined. The wet weight/dry weight ratio of the lung and albumin concentrations in bronchoalveolar lavage fluid were analyzed as indices of pulmonary edema. Endotoxin decreased the lung compliance and PaO2 and increased the wet weight/dry weight ratio, neutrophil counts, and albumin concentrations in bronchoalveolar lavage fluid. The bronchoalveolar lavage fluid concentrations of thromboxane B2 in bronchoalveolar lavage fluid were increased by infusion of endotoxin. Aminoguanidine attenuated these changes. Endotoxin caused extensive morphologic lung damage, which was lessened by aminoguanidine.
Aminoguanidine given intravenously before and after endotoxin attenuated endotoxin-induced lung injury in rabbits. These findings suggest that inducible nitric oxide synthase inhibition may be useful in the treatment of endotoxin-induced lung injury. However, further studies are required to determine the optimal dosage of aminoguanidine, when the inhibitor is given alone as therapy after lung injury.
评估选择性诱导型一氧化氮合酶抑制剂氨基胍对兔内毒素诱导的急性肺损伤的影响。
前瞻性、盲法、对照实验室研究。
大学研究实验室。
28只雄性兔。
动物被随机分为四组接受以下四种处理之一(每组n = 7):仅输注生理盐水(S-S组)、输注生理盐水和氨基胍(S-AG组)、输注大肠杆菌内毒素(60分钟内输注5 mg/kg)(E-S组)、输注内毒素和氨基胍(E-AG组)。在内毒素(E-S和E-AG组)或生理盐水(S-S和S-AG组)输注前15分钟,动物静脉注射1 mg/kg氨基胍(S-AG和E-AG组)或生理盐水(S-S和E-S组)。在内毒素或生理盐水输注结束后1小时给予相同剂量的氨基胍或生理盐水。兔肺用40%氧气通气。
在通气期间(6小时)记录血流动力学、外周白细胞计数和动脉血氧分压(PaO₂)。在进行这些观察后,测定肺力学、支气管肺泡灌洗液体细胞成分以及支气管肺泡灌洗液体中血栓素A₂和前列环素代谢物的浓度。分析肺湿重/干重比和支气管肺泡灌洗液体中白蛋白浓度作为肺水肿指标。内毒素降低了肺顺应性和PaO₂,并增加了肺湿重/干重比、中性粒细胞计数以及支气管肺泡灌洗液体中白蛋白浓度。输注内毒素使支气管肺泡灌洗液体中血栓素B₂浓度升高。氨基胍减轻了这些变化。内毒素导致广泛的肺部形态学损伤,氨基胍使其减轻。
在内毒素输注前后静脉给予氨基胍减轻了兔内毒素诱导的肺损伤。这些发现表明诱导型一氧化氮合酶抑制可能有助于治疗内毒素诱导的肺损伤。然而,需要进一步研究以确定氨基胍的最佳剂量,以及该抑制剂在肺损伤后单独作为治疗药物使用时的情况。