腹膜炎时腹膜通透性的变化  

CHANGES OF PERITONEAL MEMBRANE PERMEABILITY IN THE PERITONITIS

作　　者：罗琼[1] 黄烈城[2] 

机构地区：[1]深圳市中心医院,深圳518036 [2]海南省人民医院,570311

出　　处：《海南医学》2000年第6期64-65,58,共3页Hainan Medical Journal

摘　　要：目的腹膜透析并发腹膜炎的特征性改变是炎症反应导致腹膜对细胞、蛋白和小分子溶质的通透性增加，但腹膜通透性改变的时间及机制并不清楚．本实验采用兔动物模型研究腹腔感染时腹膜通透性改变的时间依赖关系。方法我们分别用免腹腔内注射大肠杆菌（Ｅ． ｃｏｌｉ） ４×１０６ＣＦＵ制成兔急性腹膜炎动物模型．分别对其感染后８小时（系列一）及感染２４小时后（系列二）腹膜通透性的变化进行了研究。结果系列一结果表明腹腔内注入Ｅ，ｃｏｌｉ４小时起就出现白细胞向腹腔移行和腹膜对蛋白质的通透性增加．然而此时腹膜对肌酐及葡萄糖的通透性无改变。系列二结果表明腹腔内注射Ｅ．ｃｏｌｉ２４小时后腹膜对肌酐及葡萄糖的通透性增加，而此时腹膜对蛋白的通透性已无明显变化。结论在兔腹膜炎动物模型中腹膜对小分子物质通透性增加出现在对蛋白质通透性增加之后．说明二者可能通过不同的机制管理。Characteristic signs of peritonitis during peritoneal dialysis reflect an increase in the permeability of the peritoneal membrane to cells, protein and solutes of low molecular weight. changes induced by the inflammatory response to infection within the peritoneal cavity. We determined the timedependent changes in peritoneal membrane permeability induced by inflammatory stimulus added to the peritoneal cavity in a rabbit model. Methods Separate experimental protocols were employed to determine changes in the peritoneal permeability during the first 8 hours (series 1 experiments) or 24 hours (series 2 experiments) after intraperitoneal injection of the inflammatory stimulus. Results Series 1 experiment demonstrated that leukocyte migration into the peritoneal cavity and peritoneal permeability to toatl protein was increased approximately 4 hours after intraperitoneal injection of E. coli using dialy- sate containing saline: however. no changes in peritoneal membrane permeability to creatinine or glucose were observed. Series 2 experiments demonstrated increases in peritoneal membrane permeability to both creatinine and glucose 24 hours after intraperitoneal injection of E. colt into the peritoneal cavity: however. no change in Peritoneal membrane permeability to total protein was observed. Conclusion We conclude that enhanced peritoneal membrane permeability to small solutes occurs subsequent to increases in protein loss during peritonitis in a rabbit model and are likely governed by different mechanisms.

关 键 词：腹膜炎 腹膜通透性 白细胞 蛋白质 腹膜透析 

分 类 号：R572.1[医药卫生—消化系统] R459.5[医药卫生—内科学]