エンドトキシンショック及びその治療法が血小板動態へ及ぼす影響

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Platelet counts or function and hemodynamics in endotoxin shock were investigated in dogs. E. Coli endotoxin (3 mg/kg, LD100) was administrated intravenously to dogs which were anesthetized with pentobarbital and ventilated mechanically. 1) In all groups, platelet aggregation decreased 3 minutes after administration of Pndotoxin, which would be caused by decrease of platelet, thereafter increased. 2) Changes of platelet adhesion did not show any definite tendency. However, platelet adhesion decreased 3 minutes after administration of endotoxin with posttreatment of aspirin (50mg/kg), and after infusion of lactated Ringer's solution, but increased after infusion of low molecular weight dextran solution, and either pretreatment of methylprednisolone (30mg/kg) or posttreatment of methylprednisolone (30mg/kg) . The similar increase was observed in the control group received endotoxin alone. 3) All groups except the group received dextran solution showed marked decrease of platelet 3 minutes after administration of endotoxin, and then increase. The decrease of platelet which could be caused by trapping in lung did not cause the disturbance of gas exchange in lung. Therefore, a fall of Pao2, Paco2 and Pvo2 in early stage of shock, and a rise of Paco2 and Pvo2 in late stage of shock, appeared to result from reduced cardiac output and impairment of tissue perfusion. 4) FDP increased within 3 minutes after administration of endotoxin in all groups. Infusion of low molecular weight dextran solution or lactated Ringer's solution, and posttreatment of aspirin suppressed slightly increase of FDP. There was no relation among platelet counts, fibrinolysis and FDP. 5) Coucerning platelet, posttreatment of aspirin and pretreatment of methylprednisolone were effective. On the other hand, all therapies studied, especially low molecular weight dextran, improved circulatory state.
学校法人昭和大学・昭和医学会の論文

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持丸賢二
昭和大学医学部麻酔学教室

エンドトキシンショック及びその治療法が血小板動態へ及ぼす影響

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