HEMORRHAGIC-SHOCK INDUCES BACTERIAL TRANSLOCATION FROM THE GUT
HEMORRHAGIC-SHOCK INDUCES BACTERIAL TRANSLOCATION FROM THE GUT
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DOI：
10.1097/00005373-198807000-00002
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发表时间：
1988-07-01
影响因子：
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通讯作者：
SPECIAN, RD
中科院分区：
文献类型：
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作者：
BAKER, JW;DEITCH, EA;SPECIAN, RD
失血性休克后脓毒症和多器官衰竭很常见。当前实验的目的是确定失血性休克是否会促进细菌从肠道转移到内脏器官。受到假电击24小时，或电击30、60或90分钟（30毫米汞柱）后，处死大鼠并定量培养其器官以检测易位细菌。失血性休克持续时间与24小时死亡率之间存在直接关系（p=0.02）。在假休克大鼠中，细菌没有从肠道转移，但在失血性休克大鼠中却转移到了肠系膜淋巴结、肝脏和脾脏（p < 0.01）。接受 90 分钟电击的大鼠比接受 30 或 60 分钟电击的大鼠表现出更大程度的细菌移位（p < 0.05）。最常见的易位细菌是大肠杆菌和肠球菌。失血性休克损伤肠粘膜并引起上皮下水肿和局灶性坏死。因此，失血性休克随后回输流出的血液会破坏肠道屏障，并使肠道内通常含有的本土细菌引起全身感染。
Sepsis and multiple organ failure are common after hemorrhagic shock. The goal of the current experiments was to determine whether hemorrhagic shock would promote the translocation of bacteria from the gut to visceral organs. Twenty-four hours after being subjected to sham shock, or 30, 60, or 90 minutes of shock (30 mm Hg), rats were sacrificed and their organs quantitatively cultured for translocating bacteria. There was a direct relationship between the duration of hemorrhagic shock and the 24-hour mortality rate (p= 0.02). Bacteria did not translocate from the gut in the sham-shock rats, but did translocate to the mesenteric lymph nodes, livers, and spleens of the rats subjected to hemorrhagic shock (p< 0.01). Rats subjected to 90 minutes of shock shock exhibited a greater degree of bacterial translocation than rats receiving 30 or 60 minutes of shock (p< 0.05). The most common translocating bacteria were Escherichia coli and Enterococcus. Hemorrhagic shock injured the gut mucosa and caused subepithelial edema and focal areas of necrosis. Thus hemorrhagic shock followed by reinfusion of shed blood disrupts the gut barrier and allows indigenous bacteria normally contained within the gut to cause systemic infections.