• 作者： 徐剛; 汪大衛; 高尚志; 沈建業
• 作者服務機構： 國防醫學院內科學科; 三軍總醫院胸腔內科
• 中文摘要： 本文在十條麻醉狗進行了大腸桿菌內毒素和中性白血球刺激劑PMA對循環血液中之中性白血球計數、氣體交換、肺沖洗液之蛋白濃度、肺循環血流動力學以及肺病理解剖的影響進行了研究。其中6條狗接受1μg/kg內毒素和l0μg/kgPMA；4條狗接受同量之內毒素，但PMA量減半。內毒素加10μg/kg PMA可引起循環白血球迅速而猛烈之下降，其計數（每mm）由4081±1041降至303±119；動脈血氧分壓（PaO）49.1±2.4 mmHg，肺泡一動脈氧分壓差（A-aDO）較基線顯著升高。此組動物之肺臟解剖可見嚴重損傷：水腫及明顯之片狀出血並出血性肺實變，且常有泡沫性水腫液從氣管湧出。內毒素加5 μg/kg PMA組，中性白血球無明顯減少；Pa0和A-aD0維持相對穩定。肺沖洗液中蛋白濃度和肺濕／乾比重在10μg/kg組較5μg/kg組明顯為高（P<0.05）。本研究結果說明給內毒素及PMA，中性白血球減少之程度與肺血管損傷之程度平行；中性白血球在急性水腫性肺損傷發病機轉中具重要作用。
• 英文摘要： The effects of Escherichia coli endotoxin and phorbol myristate acetate (PMA), a potential stimula-tor of polymorphonuclear leukocyte (PMN), on circulating PMN counts, gas exchange, protein concentra-tion of lavage fluid, pulmonary hemodynamics and pathology of the lung were studied in ten anesthetizeddogs. Six dogs were infused with 1 μg/kg endotoxin plus 10 μg/kg of PMA; four other dogs were infusedwith the same amount of endotoxin but 5 μg/kg of PMA. After administration of endotoxin plus 10 μg/kgPMA, the number of circulating PMN (per mm) decreased dramatically from 4081 ± 1041 to 303 ± 119,arterial oxygen partial pressure (Pa0) dropped to 49.1 ± 2.4 mmHg and the arterial alveolar oxygen partialpressure difference (A-a D0) increased significantly above baseline. Lungs from this group appeared to begrossly damaged: edema with distinct petechial hemorrhage and areas of hemorrhagic consolidation; frothyedema fluid often emanated from the tracheas. The group infused with endotoxin plus 5 μg/kg PMA show-ed no significant decrease in the number of PMN; Pa0 and A-a DO maintained comparatively stable.Protein concentration of lavage fluid and lung wet/dry weight ratios in dogs of 10 μg/kg PMA group weresignificantly increased (P<0.05) as compared to those of 5 μg/kg PMA group. Our study showed that themagnitude of leukopenia after endotoxin and PMA was paralleled with the severity of lung vascular injury.These results support the potential role of PMN in the pathogenesis of acute edematous lung injury.
• 中文關鍵字： ARDS; lung vascular injury; Endotoxin; PMA
• 英文關鍵字： --