肝网状内皮细胞系统功能损害与肺损害的关系

Relationship between functional damage of hepatic reticuloendothelial system and pulmonary damage

内毒素血症是严重革兰氏阴性菌感染导致肺损害发生的关键因素。肝脏做为门脉血流进入全身循环的大滤器,肝脏网状内皮细胞系统功能损害将不能很好地清除血中内毒素,从而容易导致肺损害。通过本实验发现,肝网状内皮细胞系统被封闭的实验组内毒素血症,阳性率明显高于对照组(p<0.05),其肺损害程度亦较对照组明显为重,从而证实了上述推断,并据此进一步提出对于严重革兰氏阴性菌感染病人,早期保护或改善肝网状内皮细胞系统功能,可以防止或减轻肺损害及ARDS发生的设想。

Endotoxin is the key etiologic factor of pulmonary damage secondary to severe infection of Gram negative bacilli. As the liver is a large filter through which portal blood flows into the systemic circulation, the endotoxin can not be effectively removed from the blood in case the function of reticuloendothelial system (RES) is damaged, thus, leading to pulmonary damage. This experiment showed that the incidence of endotoxemia in the experimental group with blocked hepatic RES was significantly higher than that in the control group (P<0.05). Also, the pulmonary damage in the experimental group is more severe than the control group. This verified the above mentioned inference. Accordingly, it is suggested that early protection or improvement of the function of hepatic RES may prevent or relieve pulmonary damage and avoid the occurrence of ARDS in patients with severe infection of Gram negative bacilli.