抗生素的应用与失血性休克肠源性释放的关系

目的:探讨失血性休克时使用抗生素是否会增加肠源性内毒素释放及其意义。方法:制作大鼠失血性休克模型,分别通过静脉注射给予罗氏芬、环丙沙星及庆大霉素,休克复苏后6h活杀动物,取门静脉血,动态观察门静脉血浆中内毒素的变化。结果:大鼠失血性休克后,对照组、庆大霉素组和环丙沙星组门静脉血内毒素水平明显升高,后两组内毒素水平高于对照组(P<0.01),两组间差异无显著性(P>0.05);罗氏芬组内毒素低于庆大霉素组、环丙沙星组和对照组(P<0.01)。结果:应激状态下不同抗生素的使用导致了不同的内毒素释放水平,合理选择抗生素,减少内毒素释放对临床具有重要意义。

Relationship between the use of antibiotics and the release of intestinal origin endotoxin after hemorrhagic shock

Objective To investigate the characteristics of endotoxin released from portal vein blood induced by different antibiotics under killing bacteria. Methods 62 Sprague-Daweley rats were randomly divided into five groups: normal group (NG,n=6), control group (CON,n=14), gentamycin group (GEN group, shock gentamycin,n=14),cyclopropane group (CYC group,shock cyclopropane, n=14) and rocephin group (ROC group, shock rocephin,n=14).All rats were injected with above-mentioned antibiotic at beginning and then an experimental rat model of hemorrhagic shock was set up. The blood samples from portal vein were taken at 3 h and 6 h after shock resuscitation for bacterial endotoxin assay.Results Compared with control group, the endotoxin levels were higher in GEN group and CYC group(P< 0.01), but the endotoxin level in ROS group was lower than that of GEN group, CYC group (P< 0.01 respectively) and CON group(P< 0.05). Conclusion The different antibiotics may reduce different endotoxin liberating levels. It is important for decreasing the release of endotoxin to lay stress on the selection of antibiotics in severe disease.