抗炎药能抑制内毒素休克大鼠血浆CGRP浓度的升高

本实验观察了消炎痛、布洛芬、纳洛酮和吗啡治疗对清醒大鼠注射内毒素5 mg/kg 3 h血浆 CGRP 浓度的影响。结果表明,消炎痛、布洛芬和纳洛酮均明显地抑制休克时血浆CGRP 的升高,同时还明显地减轻休克时的肠道损伤;而吗啡治疗则无明显影响。本实验结果提示:体内炎症介质之一的前列腺素可能是引起内毒素休克时 CGRP 释放增加的重要内源性因子。     

阿片受体阻断剂纳洛酮治疗休克的作用和机制

循环性休克时,内阿片肽释放量显著增多,可直接或间接抑制心血管系统。纳洛酮静脉或中枢给药,可改善多种动物的失血性、内毒素性、内脏缺血性、脊髓损伤性等休克状况,并能提高生存率或延长生存时间。注射α受体阻断剂、摘除肾上腺、充分耗竭儿茶酚胺,或脑室内注射5-羟色胺,均可取消纳洛酮升压、抗休克作用。临床试用治疗感染性等休克,取得一定效果。本文作者对其进一步临床应用的主要问题提出了意见和建议。     

刺激大鼠尾壳核对脑内脑啡肽含量的影响

为确定刺激某一脑区时,远隔脑区脑啡肽含量是否改变;如有改变,甲-脑啡肽和亮-脑啡肽的变化是否一致。本工作在乌拉坦麻醉大鼠上,用放射免疫测定方法测定了电刺激尾壳核对六个脑区(下丘脑、纹状体、丘脑、海马、皮层及脑干)两种脑啡肽含量的影响。放射免疫测定的结果表明:(1)动物经乌拉坦麻校舍醉及手术操作后,除纹状体外,其它五个脑区亮-脑啡肽含量均明显降低,甲-脑啡肽含量只有下丘脑和丘脑明显降低,其它脑区无显著变化。(2)在乌拉坦麻醉及手术的基础上,再刺激尾壳核,除丘脑无显著变化外,其它五个脑区甲-脑啡肽含量均明显降低,亮-脑啡肽含量均明显升高,甲-脑啡肽/亮-脑啡肽比值减少(其中纹状体的比值改变无统计学显著性)。以上结果表明,刺激大鼠尾壳核可明显影响远隔脑区脑啡肽含量。关于甲-脑啡肽和亮-脑啡肽反向变化的意义有待进一步研究。     

大鼠烫伤后不同时程侧脑室注射强啡肽A(1—13)抗血清对烫伤休克的影响

近年来的研究工作表明,内源性阿片肽与休克密切相关。在内毒素性休克、低血容量性休克和脊髓损伤性休克时,血浆和脑脊液中内源性阿片肽有不同程度的升高,应用阿片肽受体拮抗剂纳洛酮可对抗休克。我们在烫伤休克的研究中观察到,大鼠烫伤后,某些脑区和血浆中强啡肽A(1-13)[DynA(1-13)]免疫活性物质的含量有显著变化,烫后外周静脉给予DynA(1～13)抗血清,可改善大鼠心血管功能,延长存     

人血浆亮脑啡肽样物质放射免疫测定法及其临床初步应用

本文报告了血浆亮脑啡肽样物质(LEK)的放射免疫测定法。用 TG-ECDI-LEK 背部皮内多点免疫家兔,获得高特异性的抗 LEK 血清,最小检出量5pg,多种肽类及吗啡、纳洛酮对此均无明显干扰。血浆迅速酸化及抑肽酶等能有效防止脑啡肽(EK)的降解。血浆 EK 可被 XAD-2树脂吸附和用水合甲醇洗脱。本法测定人血浆 LEK 为127.9±5.4pg/ml(m±S.E.M,n=61).作者观察到胰岛素低血糖休克后血浆 LEK 增加,嗜铬细胞瘤患者血 LEK 增加,提示肾上腺體质可能是它的来源之一。     

下丘脑前区的脑啡肽参与急性心肌缺血减弱颈动脉窦升压反射的效应

家兔急性心肌缺血时,下丘脑等脑区亮啡肽(L-Enk)含量显著升高,延脑未见明显变化,向下丘脑前区直接注射微量L-Enk,同阻断冠脉效应相同,也可减弱窦升压反射。该区注射纳络酮(Nx)可逆转心肌缺血减弱窦升压反射的效应,而对正常兔的窦升压反射没有明显影响。提示:急性心肌缺血时,下丘脑前区的脑啡肽可被激活,并参与窦升压反射的调节。但在正常情况下,这些脑啡肽可能处在非活动状态,在窦升压反射的调节中可能不起重要作用。     

失血性休克早期白细胞介素1活性升高的机制——内毒素与白细胞介素1

本文观察了失血性休克条件下大鼠白细胞介素１（ＩＬ－１）与内毒素的关系。结果表明：失血性休克早期血浆ＩＬ－１及ＥＴ均明显升高,前者升高在先;无菌大鼠失血性休克后ＩＬ－１活性也升高,但ＥＴ无明显变化;预先给大鼠口服乳果糖以清洁肠道,或静注内毒素抗体,休克后血浆ＩＬ－１活性仍然明显升高,而血浆ＥＴ无明显升高;大鼠失血后１ｈ将失血回输再灌注后５ｄ血浆ＩＬ－１与ＥＴ呈平行性变化,乳果糖或抗内毒素抗体治疗后,     

大鼠侧脑室注射高渗盐水引起血压上升过程中心房钠尿肽和血管升压素的变化

为研究中枢渗透压刺激升压的机制,在大鼠侧脑室内给予高滲人工脑脊液,记录颈动脉压和心率变化,给药10min 后,用放射免疫法测定血浆、下丘脑和垂体中的心房钠尿肽和升压素。结果表明:中枢给予高渗人工脑脊液后,血浆中升压素水平明显增加,心房钠尿肽没有明显改变,下丘脑和垂体中的心房钠尿肽含量增加,而升压素含量下降。     

针刺增加家兔脑池脑脊液中内啡肽含量

本文用放射受体及放射免疫分析法分别测定脑池脑脊液中内啡肽总量及脑啡肽含量来研究内啡肽释放是否亦表现在脊髓上水平。第一部分实验20只家兔,均分为对照、手针足三里、电针足三里及电刺激脑中央灰质4组。手针、电针及电刺激脑后在局麻中穿刺脑池吸取脑脊液1毫升,用 SephadexG-10柱层析去盐,盐峰前洗脱液合并成组分Ⅰ,盐峰后洗脱液合并成组分Ⅱ,后者与已知脑啡肽洗脱部位相同。用放射受体法测吗啡样活性,手针、电针及电刺激脑组的组分Ⅰ平均值比对照组分别增加22%、31%和20%,组分Ⅱ分别增加10%、15%和2%,但数据较离散均无统计显著意义。第二部分实验家兔15只,均分为对照、脑室内注射杆菌肽50微克及脑室内注射杆菌肽50微克+手针足三里3组。同法抽取脑脊液用放射免疫法测定脑啡肽含量。结果单注射杆菌肽不增加脑啡肽含量,但杆菌肽+手针组增加十分显著,为对照组的3倍。说明静息状态下脑啡肽神经原活动程度较低,针刺可使它大大激活。     

脑啡肽在豚鼠、兔回肠环肌收缩中的作用

豚鼠、兔回肠的未分离环肌,在电场刺激下,可发生缓慢的节律性收缩。此收缩可被纳洛酮完全消除,或被阿托品部分减弱。与此相反,亮脑啡肽和乙酰胆碱司使节律性收缩明显增强。此外,单独用乙酰胆碱(4.3—5.7μg/ml)或亮脑啡(1.4—2.8μg/ml)作用于分离环肌时,均未能使其发生任何收缩反应。但在乙酰胆碱4.3μg/ml作用的基础上,仅用1.4μg/ml的亮脑啡肽,或再用电场刺激时,则均能使其发生明显的收缩。上述结果提示,环肌的收缩可能需要脑啡肽和乙酰胆碱共同作用。本实验的结果还表明,脑啡肽对环肌收缩的作用与对纵肌相反,它使前者兴奋,使后者抑制。     

淋浆对内毒素休克大鼠微循环障碍的干预作用

目的：探讨淋浆对内毒素休克的干预作用及其机制。方法：Wistar雄性大鼠60只,随机分为对照组、模型组和淋浆组,以颈静脉注射LPS（15 mg/kg）复制内毒素休克模型,造模15 min后,淋浆组自颈静脉注射正常淋浆（占全血量1/15）,观察对平均动脉血压（MAP）、回肠下段肠系膜微循环、细静脉壁白细胞粘附数、血浆P-选择素和细胞间粘附分子（ICAM-1）含量的影响。结果：正常淋浆可防止内毒素休克的MAP进行性下降,解除肠系膜微血管的病理性缩窄,减少白细胞在细静脉壁的粘附,改善微循环的流态,降低血浆P-选择素和ICAM-1的水平。结论：小量正常淋浆对LPS攻击导致内毒素休克的微循环障碍和低血压均有良好的干预作用,其机制与减少细胞粘附分子生成有关。     

刺激兔下丘脑防御反应区时脑脊液内亮啡肽免疫活性增强

用放射免疫测定法观察到,电刺激兔下丘脑防御反应区时,中脑导水管末端的脑脊液样品内亮啡肽免疫活性明显增强。结果提示,下丘脑防御反应区兴奋时脑内亮啡肽释放增多。     

Distribution of respiratory muscle and organ blood flow during endotoxic shock in dogs

Respiratory muscle blood flow and organ blood flow during endotoxic shock were studied in spontaneously breathing dogs (SB, n = 6) and mechanically ventilated dogs (MV, n = 5) with radiolabeled microspheres. Shock was produced by a 5-min intravenous injection of Escherichia coli endotoxin (0.55:B5, Difco, 10 mg/kg) suspended in saline. Mean arterial blood pressure and cardiac output in the SB group dropped to 59 and 45% of control values, respectively. There was a similar reduction in arterial blood pressure and cardiac output in the MV group. Total respiratory muscle blood flow in the SB group increased significantly from the control value of 51 +/- 4 ml/min (mean +/- SE) to 101 +/- 22 ml/min at 60 min of shock. In the MV group, respiratory muscle perfusion fell from control values of 43 +/- 12 ml/min to 25 +/- 3 ml/min at 60 min of shock. In the SB group, 8.8% of the cardiac output was received by the respiratory muscle during shock in comparison with 1.9% in the MV group. In both groups of dogs, blood flow to most organs was compromised during shock; however, blood flow to the brain, gut, and skeletal muscles was higher in the MV group than in the SB group. Thus by mechanical ventilation a fraction of the cardiac output used by the working respiratory muscles can be made available for perfusion of other organs during endotoxic shock.     

Protective effect of OK-432 on mice against endotoxemia and infection with Pseudomonas aeruginosa and Salmonella enteritidis

OK-432 has been used clinically as a biological response modifier for cancer therapy. We investigated here the protective effects of OK-432 against endotoxic shock and infectious death caused by Pseudomonas aeruginosa and Salmonella enteritidis in mice and proposed a possible mechanism. Pretreatment of OK-432 reduced the lethality of lipopolysaccharide (LPS)-induced endotoxic shock in D-(+)-galactosamine-sensitized C3H/HeN mice. OK-432 did not affect the TNFalpha production in blood, but it did decrease the susceptibility to TNFalpha. Furthermore, an acceleration of LPS clearance from blood was detected. The pretreatment of OK-432 also decreased the lethality of mice in bacterial infection caused by P. aeruginosa and S. enteritidis. The rapid decrease of the viable bacteria from the circulating blood and in spleen and liver in mice was observed in a manner similar to LPS clearance. These findings indicate that the protective effect of OK-432 against the endotoxemia and bacteremia may depend on an up-regulation of clearance of LPS and bacteria and the augmented resistance to TNFalpha.     

外源性硫化氢对家兔内毒素休克诱发肺动脉高压的干预作用

目的:探讨外源性硫化氢(H₂S)对家兔内毒素休克(ES)诱发肺动脉血管反应性的影响。方法:本实验采用家兔经颈静脉注射脂多糖(LPS,8 mg/0.8 ml/kg)复制家兔ES模型,并提前15 min腹腔注射H₂S供体硫氢化钠(NaHS,28μmol/kg)进行干预。随机将新西兰大耳白家兔分为4组(n=8):溶剂对照组、LPS组、LPS+NaHS组和NaHS组。监测平均动脉压(MAP)和平均肺动脉压(MPAP)的变化;应用血管环张力测定技术,检测各组家兔离体肺动脉张力变化;应用光镜和扫描电镜分别观察肺动脉管壁结构及肺动脉内皮细胞超微结构变化。结果:(1)注射LPS后家兔出现MAP降低、MPAP升高,成功复制家兔ES模型;与LPS组相比,LPS+NaHS组家兔MPAP在各个时间点均显著降低(P均﹤0.05);(2)与正常对照组相比,LPS组家兔肺动脉对苯肾上腺素(PE)的收缩反应增强,对乙酰胆碱(ACh)的舒张反应降低(P均﹤0.01);与LPS组相比,LPS+NaHS组家兔肺动脉对PE的收缩反应降低,而对ACh的舒张反应增强(P均﹤0.05)。...     

刺激兔下丘脑对心肌局部血流量和脊髓中间外侧柱P物质含量的影响

本工作在48只氯醛糖-尿酯混合液静脉麻醉,三碘季铵酚制动,人工呼吸,切断两侧迷走神经,并静脉注射心得安(15mg/kg)阻断 β 受体的兔上进行。实验结果显示:1.电刺激下丘脑背内侧核(DMH),可观察到平均动脉血压(MABP)增加,心率无明显变化。用放射性生物微球技术测定心肌局部血流量(RMBF),看到刺激左侧或右侧 DMH 均使左室 RMBF 明显减少,前者减少20.9%,而后者减少13.2%,两者相比差异有显著性(p<0.05),但右室RMBF 改变不明显。2.左侧或右侧 DMH 刺激使左室前壁心外膜电图(EECG)ST 段明显抬高,EECG-ST 段变化与 RMBF 呈负相关(r=-0.825,p<0.01),但与血压变化呈非线性相关(r=0.347,p=0.159)3.用放射免疫测定技术(RIA)测定脊髓胸2-5(T_(2-5))节段中间外侧柱(IML)中 P 物质(SP)含量,观察到在刺激 DMH 诱发心肌缺血的动物中,两侧IML 内 SP 的含量均显著减少,以刺激的同侧 IML 时变化更明显。上述结果提示:下丘脑背内侧核兴奋可诱发冠状动脉痉挛,心肌局部血流量减少,其中枢机理可能与脊髓 IML 部位 SP 释放,诱发交感缩冠脉作用有关。     

Leu-enkephalin actions on avoidance conditioning are mediated by a peripheral opioid mechanism

Leu-enkephalin (100 micrograms/kg, i.p.) administered to mice 5 min before training in a one way active avoidance task significantly reduced the number of avoidances observed in the peptide treated animals. This impairing action of Leu-enkephalin was partially attenuated by methylnaloxonium (naloxonium), a quarternary form of naloxone with a limited ability to penetrate the blood brain barrier. Passive immunization (i.v.) of mice with a Leu-enkephalin antiserum 4 hrs before training produced an effect on avoidance conditioning that was the opposite to that observed with Leu-enkephalin alone. That is, passive immunization increased the number of avoidances observed in the treated mice. The results suggest that Leu-enkephalin actions on avoidance conditioning are mediated by a peripheral opioid mechanism, that leu-enkephalin may have a primary site of action outside the blood brain barrier, and that peripheral Leu-enkephalin systems may normally operate to influence conditioned avoidance behavior.     

内皮素在休克中的发病学意义

内皮素是新近发现的血管内皮细胞产生的一种生物活性多肽,本工作用特异性放免法测定发现晚期败血症休克病人血浆内皮素水平显著增加;给健康大鼠持续滴注内皮素即能复制出典型休克模型(Endothelin-shock);给失血性休克大鼠滴注小剂量内皮素则恶化休克促进其不可逆发展。实验结果提示内皮素可能是机体的内源性致损伤因子,是参与休克发生发展的重要体液因素之一。     

脂多糖诱导小鼠脏器中胞间粘附分子-1的表达

为研究脂多糖（lipopolysaccharide,LPS)诱导的内毒素休克小鼠多种脏器中胞间粘附分子-1（intercellu-lar adhesion molecule-1,ICAM-1)表达的差异。用5mg/kgLPS腹腔注射小鼠后,分别采用Western blotting和RT-PCR法检测组织中ICAM-1蛋白和mRNA的表达情况,结果显示,在正常小鼠,ICAM-1蛋白和mRNA的表达在肺中最多,其次是脾脏,在肾脏和肠有少量表达,在肝脏和心脏中未能检出,LPS腹腔注射后6h可诱导小鼠发生内毒素休克,此时,ICAM-1蛋白表达仍以在肺中最多,在肝、脾、心、肾和肠依次减少;其中在肺,肾和脾分别比正常时增加4.5、3.0和1.5倍,而且在正常时不能检出的肝和心中呈现阳性,但在肠中则变化不大,脏器中ICAM-1mRNA亦相应显著增加,上述结果表明,在LPS诱导的内毒素休克小鼠的多种脏器中ICAM-1蛋白和mRNA表达显著增加,脏器间ICAM-1表达上调的差异可能带来内毒素休克时脏器的不同易伤性,抑制ICAM-1的表达可能对内毒素休克的防治有重要的意义。     

Interference of the PAF-acether antagonist BN 52021 with endotoxin-induced hypotension in the guinea-pig

Because of the potential role of PAF-acether in the pathogenesis of endotoxin shock, we examined the preventive and curative effects of BN 52021, a new PAF-acether antagonist in guinea-pig challenged with S. Typhimurium endotoxin. A biphasic reduction of mean arterial pressure was elicited by i.v. endotoxin (300 micrograms/kg) in control animals, with a rapid drop of blood pressure (maximal decrease within 10 min), partial recovery at 20 min and a second gradual decrease after 30 min. Treatment with BN 52021 injected 15 min prior to endotoxin reduced the initial rapid drop of blood pressure from 38.5 +/- 5 mmHg in vehicle-treated controls (n = 15) to 17 +/- 3 mmHg (p less than 0.01) in animals treated with 1 mg/kg BN 52021(n = 10) and to 9.5 +/- 8 mmHg (p less than 0.01) in guinea-pigs treated with 6 mg/kg BN 52021 (n = 5). The early hypotensive phase was associated with severe thrombocytopenia-leukopenia; only the thrombocytopenia was reduced by BN 52021. The prolonged secondary phase of hypotension was reduced by BN 52021 pretreatment whereas a small increase of hematocrit persisted. The two phases of the arterial pressure profile during endotoxic shock were not observed in animals previously made thrombopenic by rabbit and anti-platelet serum and only the late hypotensive phase persisted. This late hypotension induced by endotoxin in thrombopenic animals was suppressed by BN 52021 pretreatment suggesting that BN 52021 may act via a platelet-independent mechanism. The intravenous injection of BN 52021 during the prolonged secondary phase of shock was followed by an immediate increase of the depressed blood pressure. This increase of blood pressure was dose-dependent, maximum at 6 mg/kg BN 52021, and observed in normal and thrombopenic animals. The interference of BN 52021 with endotoxin shock may be related to its PAF-acether antagonist properties and suggests that PAF-acether is an important participant in endotoxic shock.