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目的：了解内毒素（ＬＰＳ）、肿瘤坏死因子（ＴＮＦ）和白细胞介素１（ＩＬ１）对实验性内毒素休克时肺损伤的保护作用。方法：实验分３组：Ⅰ组为假灌流组，Ⅱ组、Ⅲ组大鼠在内毒素休克早期开始分别给予活性炭（Ⅱ组）、大孔树脂ＡｍｂｅｒｌｉｔｅＸＡＤ７（Ⅲ组）血液灌流，结果与Ⅰ组作比较。结果：Ⅱ组ＬＰＳ、ＩＬ１水平明显降低，而Ⅲ组ＴＮＦ水平明显降低。Ⅱ组、Ⅲ组外周血白细胞数分别为（４．０±０．４）×１０９／Ｌ和（３．９±０．４）×１０９／Ｌ，均明显高于Ⅰ组〔（３．１±０．２）×１０９／Ｌ〕，Ｐ均＜０．０１；支气管肺泡灌洗液（ＢＡＬＦ）中的白细胞数〔（８．５±０．１）×１０９／Ｌ，（８．９±０．１）×１０９／Ｌ〕、肺系数（０．６４±０．０６，０．６６±０．０６）以及肺组织浸润的中性分叶核粒细胞数（２９．６±７．９／ＨＰ，３４．５±４．１／ＨＰ）均明显低于Ⅰ组〔（１２．３±１．８）×１０９／Ｌ，０．７５±０．０７，４８．６±６．６／ＨＰ〕，Ｐ均＜０．０１或＜０．０５。Ⅱ组、Ⅲ组的肺组织学改变亦较Ⅰ组明显减轻。结论：清除血液中致病介质可能对内毒素休克时的肺损伤产生保护作用。
Objective: To investigate the protective effects of endotoxin (LPS), tumor necrosis factor (TNF) and interleukin-1 (IL1) on lung injury induced by endotoxic shock. Methods: The experimental group was divided into three groups: group I was fake perfusion group, group Ⅱ and group Ⅲ were treated with activated carbon (group Ⅱ) and Amberlite XAD7 (group Ⅲ) respectively at the early stage of endotoxic shock, and the results were compared with group Ⅰ compared to. Results: The levels of LPS and IL1 in group Ⅱ were significantly decreased, while the levels of TNF in group Ⅲ were significantly decreased. The numbers of leukocytes in group Ⅱ and group Ⅲ were (4.0 ± 0.4) × 109 / L and (3.9 ± 0.4) × 109 / L, respectively, which were significantly higher than those in group Ⅰ [(3.1 ± 0.2) × 109 / L], all P <0.01. The number of leukocytes in bronchoalveolar lavage fluid (BALF) was (8.5 ± 0.1) × 109 / L, (8.9 ± 0.1) × 109 / L], pulmonary coefficient (0.64 ± 0.06,0.66 ± 0.06), and neutrophil granulocyte count (29.6 ± 7.9 /HP, 34.5 ± 4.1 / HP) were significantly lower than those in groupⅠ [(12.3 ± 1.8) × 109 / L, 0.75 ± 0.07, 48.6 ± 6.6 / HP], P <0.01 or <0.05 respectively. The lung histological changes in group Ⅱ and group Ⅲ were also significantly lower than those in group Ⅰ. Conclusion: Clearing pathogenic agents in the blood may have a protective effect on lung injury induced by endotoxic shock.