摘要
目的探讨抗菌药物联合乌司他丁对酒精性肝病大鼠创伤弧菌脓毒症的实验治疗作用。方法采用酒精灌胃联合自由饮酒制作大鼠酒精性肝病模型,右下肢皮下注射创伤弧菌感染肝病大鼠,制作酒精性肝病大鼠创伤弧菌脓毒症模型15只,随机分1～3组,分别于染菌后12h经腹腔注射药物,1次12h,治疗10d。第1组用等量生理盐水作为对照,第2组应用头孢哌酮和左氧氟沙星,第3组应用头孢哌酮和左氧氟沙星联合乌司他丁。观察大鼠的活动、皮肤黏膜颜色、右下肢感染创口、存活数等。第1组大鼠死亡后,第2组和第3组治疗10d后颈动脉取血液及患肢病变组织进行细菌培养,取大鼠右大腿肌肉、肝脏、肺脏的电镜标本,观察治疗前后细胞超微结构改变。结果各组大鼠12h后,皮温升高,右下肢明显肿胀,皮肤发紫,精神萎靡,活动减少,呼吸急促。第1组大鼠均在24～48h内死亡,血液及患肢病变组织培养出创伤弧菌。2、3组大鼠药物治疗后,精神萎靡状态及呼吸急促等明显改善,3～5d后患侧大腿病变处溃破糜烂,10d后两组大鼠均存活,血液及患肢病变组织培养均为阴性。第3组与第2组比较,前者状态恢复好。抗菌药物治疗前后主要脏器细胞的超微结构改变明显减轻,抗菌药物联合乌司他丁对细胞超微结构改变减轻更为显著。结论应用足量头孢哌酮和左氧氟沙星对酒精性肝病大鼠创伤弧菌脓毒症具有显著的疗效,头孢哌酮和左氧氟沙星联合乌司他丁的疗效更佳,为临床治疗创伤弧菌脓毒症提供了可靠依据。
Objective To investigate combined effect of antimicrobial agents and Ulinastatin on vibrio vulnificus sepsis in rats with alcohol liver disease. Methods Alcohol liver disease was induced by the free drinking and stomach fed with alcohol. 15 rats with alcohol liver disease received subcutane ous inject of Vibrio vulnificus in the right legs and then randomly divided into three groups: the first group was treated with saline,the second group with antimicrobial agents and the third group with antimicrobial agents and Ulinastatin.Changes in activity,skin color and mucous membrane,the infected wound of the right leg,and survival rate were assessed. The blood and tissues of the infected legs were obtained and cultured after the first group died or from the second and the third group on the 10 days.Ultrastucture before and after treatment was studied.Result Skin temperature increased,right leg swelled,cyanosed,lethargy,activity reduced and tachypnea at 12 hours after Vibrio vulnificus infection. All rats died in the first group at 24 to 48 hours and Vibrio vulnificus was cultured from blood and tissues of the infected legs. The clinical symptoms of the second group and the third group were obviously improved, but anabrosis appeared in the right leg at 3～5 days.All rats survired in the second and the third groups and the results of cultivation of the blood and tissues of the infected leg were negative at 10 days. The third group had a better recovery than the second ,for example, the right leg swelling and, anabrosis range decreaseing at 10 days. Changes in the ultrastucture of the main organs after being treated with antimicrobial agents and Ulinastatin were more relieved than after being treated with antimicrobial agents. Conclusion Cefoperazone and Levofloxacin have good effects on Vibrio vulnificus infection in rats with Alcohol Liver Disease.But the effects of combining antimicrobial agents and ulinastatin were better.
出处
《中华急诊医学杂志》
CAS
CSCD
2005年第6期474-478,共5页
Chinese Journal of Emergency Medicine
基金
浙江省教育厅基金资助项目(20020438)
温州市科技局重大计划项目资助(Y2004A004)
