【摘要】 本文对实验性败血症休克狗血中微聚物的形成和消失进行了动态的定量观察,对部分动物血中微聚物及肺组织作了电镜检查;再一次证实我组1980年关于微聚物在内毒素休克中的作用,井进一步揭示肺对血中微聚物的清除作用的重要意义。肺清除功能良好者,生存时间长;反之,迅速死亡。本研究为临床上积极采用保护、支持休克病人的肺功能等治疗措施,提供了实验根据和理论基础。更多还原

【Abstract】 The significance of microaggregate(MA)in septic shock continued to be anelusive medical problem.Based upon our previous experiment,this study wasundertaken to determine the role of MA in experimental septic shock(ESS);and toclarify the significance of pulmonary clearance of MA in ESS.Platelet aggregates counting ratio(PACR,by Wu Hoak’s method),blood pressureand respiration were monitored before and 2～5,15,60,120,240 and 360 minutesafter bolus injection of 9×10~8 live E.Coli organisms/kg in 12 anethetized dogs.Pulmonary clearance of MA was measured by quantitative difference between PACRvalues of mixed venous blood(MVB)and aortic blood(AB).Using Electromicroscope,MA in MVB and lung capillaries were observed.Injection of equal volume of culturemedium as control(N=5).Result:ESS was induced by bolus injection of live E.Coli organisms.3/12 diedwithin 4 hrs and 9/12 survived 6～9 hrs or more.2～5 minutes after injection,a lot of MA appeared in the blood and pulmonary capillaries,associated with acutedrop of BP,suggested that obstruction of pulmonary capillaries by MA mightcontribute in acute drop of BP.The data also demonstrated that in the experimental group,those with greaterquantitative difference between PACR values of MVB and AB before injection of liveE.Coli organisms(0.313±0.033 VS.0.18±0.018)were lower value of PACR ofAB at 120～240 minutes after injection(0.387±0.013 VS.0.87±0.013)and hadshorter survival time(228±27 min VS.6～9 hrs or more)than those with littlequantitative difference between PACR values of MVB and AB before injection. Theseevidences might suggest that the more burden of pulmonary clearance beforeinjection,the more trend to failure of pulmonary clearance after injection.It seemsreasonable to assume that the presence of a lot of MA in AB indicated the failureof pulmonary clearance.Conclusion:Electromicroscopic study and PACR measurement in blood or/andin lung in 12 ESS dogs and 5 control ones had comfirmed our previous study thatMA plays key role in ESS,and provided much new information on the importantrole of pulmonary clearance of MA in blood in ESS,it suggested that the clinicalpulmonary functional suportting measures are very important for septic shockpatients.更多还原