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目的:研究抗 TNF 单抗及 L-NMMA 对内毒素休克时血流动力学的影响并探讨其作用机制。方法:动态观察内毒素休克大鼠血流动力学及血浆一氧化氮(NO)、TNF 和谷丙转氨酶(ALT)水平的变化。结果;抗体和 L-NMMA 治疗组大鼠平均动脉压(MAP)均较对照组显著增高。而血浆 NO 含量有不同程度降低。L-NMMA 对血浆 TNF 无影响。血浆 ALT 在 L-NMMA 治疗组是显著升高的。结论;抗 TNF 单抗和 L-NMMA 均能升高内毒素休克动物动脉压,并有协同作用。抗 TNF 单抗通过中和 TNF,减少 iNOS 的诱生而发挥作用,L-NMMA 的作用机制则与 TNF 无关。L-NMMA在升高 MAP 的同时,对器官功能有一定的损害作用。应用小剂量 L-NMMA 并联合抗 TNF 单抗可能更安全有效。
Objective: To study the effect of anti-TNF monoclonal antibody and L-NMMA on hemodynamics in endotoxic shock and to explore its mechanism. Methods: The changes of hemodynamics and plasma levels of nitric oxide (NO), TNF and alanine aminotransferase (ALT) in rats with endotoxic shock were observed dynamically. Results: The mean arterial pressure (MAP) in the antibody and L-NMMA treatment groups was significantly higher than that in the control group. The plasma NO levels decreased to varying degrees. L-NMMA had no effect on plasma TNF. Plasma ALT was significantly elevated in the L-NMMA treatment group. Conclusion: Both anti-TNF monoclonal antibody and L-NMMA can increase arterial pressure in endotoxic shock animals and have a synergistic effect. Anti-TNF monoclonal antibody plays a role in neutralizing TNF and reducing the induction of iNOS. The mechanism of action of L-NMMA is not related to TNF. L-NMMA increases the MAP at the same time, have some damage to organ function. It may be safer and more effective to use low-dose L-NMMA in combination with anti-TNF mAb.