THE EFFETS OF LIDOCAINE ON ENDOTOXIN-INDUCED MULTIPLE ORGAN FAILURE.

本研究旨在观察利多卡因对内毒素诱导的多器官功能衰竭（MOF）的影响。雄性日本白色家兔17只，随机分为两组：S组（对照组）8只，静脉注射内毒素（E. coli）和生理盐水; L组（n = 9），静脉注射内毒素和利多卡因。在内毒素后0小时、6小时、12小时和24小时抽取动脉血样品用于测量PaO2、GOT、GPT、BUN和肌酐。内毒素前和内毒素后24小时通过被动呼气流量-容积技术测定肺力学。内毒素后24小时处死动物。然后，取出肺、肾和肝，以测定湿干重比（W/D）和髓过氧化物酶活性。测定支气管肺泡灌洗液（BAL）中细胞因子和白蛋白浓度。肺、肾和肝也用4%戊二醛溶液固定。标本用苏木精和伊红染色，并在光学显微镜下检查。内毒素降低PaO_2和肺顺应性。林多卡因成功地减轻了氧合和顺应性的恶化。内毒素还可增加三个器官的W/D重量比，并增加BAL液中白蛋白和白细胞介素（IL）-6，IL-8。利多卡因减弱了增加。未接受利多卡因的家兔肺、肾和肝的髓过氧化物酶活性更高。内毒素引起广泛的形态学器官损害，利多卡因治疗减轻。这些结果表明，利多卡因预处理减轻兔内毒素诱导的MOF。由于利多卡因能显著降低内毒素家兔器官的髓过氧化物酶，因此，利多卡因可能部分通过抑制中性粒细胞的活化而减轻MOF。

We conducted the current study to assss the effects of lidocaine on endotoxin-induced multiple organ failure (MOF). Seventeen male Japanese white rabbits were divided into two groups : Group S (control, n=8) received iv endotoxin (E.Coli) and saline and Group L (n=9) did endotoxin and lidocaine infusion. Arterial blood samples for measurement of PaO2, GOT,GPT,BUN,and creatinine were drawn 0 hr, 6 hr, 12 hr, and 24 hr after endotoxin. Lung mechanics were measured by the passive expiratory flow-volume technique before endotoxin and 24 hr after endotoxin. The animals were killed 24 hr after endotoxin. Then, the lung, kidney, and liver were removed to determine wet to dry weight ratios (W/D) and myeloperoxidase activities. Cytokine and albumin concentrations in bronchoalveolar lavage (BAL) fluid were measured. The lung, kidney, and liver were also fixed by 4% glutaraldehyde solution. The specimens were stained with hematoxylin and eosin and examined under a light microscope. Endotoxin decreased PaO_2 and lung compliance. Lindocaine successfully attenuated deterioration of oxygenation and compliance. Endotoxin also increased the W/D weight ratio of the three organs, and albumin and interleukin (IL) -6, IL-8 in BAL fluid. Lidocaine attenuated the increases. The myeloperoxidase activities of the lung, kidney, and liver were greater in rabbits which did not receive lidocaine. Endotoxin caused extensive morphologic organ damages, which were lessened by lidocaine treatment. These results indicate that lidocaine pre-treatment attenuates endotoxin-induced MOF in rabbits. Because lidocaine markedly reduced the myeloperoxidase of the organs prepared from rabbits with endotoxin, the drug may attenuate the MOF in part by inhibiting activation of neutrophils.