[Diagnostic effect of bronchoalveolar lavage in early lung injury caused by enterogenic infection in rat].

OBJECTIVE: To study the diagnostic effect of bronchoalveolar lavage in early lung injury by observing changes in inflammatory mediators in early lung injury caused by enterogenic infection. METHODS: Eighty-four Sprague-Dawley rats were randomly divided into infection group and sham-operation group. Cecal ligation and perforation was utilized to produce abdominal infection in rats. Six groups were sacrificed respectively at 0, 24, 48, 72, 96, 120 hours after operation. The differential cell count in bronchoalveolar lavage fluid (BALF) was assessed. The concentrations of endotoxin, phospholipase A2 (PLA2) and tumor necrosis factor-alpha (TNF-alpha) in BALF, lung and plasma were assayed. RESULTS: The neutrophil percentage of BALF increased progressively. The concentrations of endotoxin, PLA2 and TNF-alpha in BALF, lung and plasma were significantly increased. The levels of endotoxin and PLA2 in lung tissue were respectively correlated positively with those in BALF and plasma (BALF and lung: r=0.904, P<0.05; BALF and plasma: r=0.895, P<0.05; lung and plasma: r=0.946, P<0.01). Significant positive correlation was also present between the TNF-alpha levels in BALF and lung (r=0.952 P<0.01), but not between the TNF-alpha level in plasma and that in lung or BALF (r=0.684, r=0.608, both P>0.05). CONCLUSION: The examinations of bronchoalveolar lavage may help discover early lung injury caused by enterogenic infection.

[Analysis of platelets in the monitoring of systemic inflammatory response syndrome of critically ill patients].

OBJECTIVE: To study the clinical significance of the variance of platelets in systemic inflammatory response syndrome(SIRS) of critical illness. METHODS: Two hundred and thirteen critically ill patients in ICU, who suffered from SIRS, sepsis and multiple organ dysfunction syndrome (MODS), were enrolled in this study and divided into two groups, survivor group (n=151) and non-survivor group (n=62). Platelet, white blood cell counts and acute physiology and chronic health evaluation II (APACHE II) score were performed immediately after hospitalization, 3 days, 7 days, and 10 days later. At the same time, the serum was collected and the level of tumor necrosis factor-alpha (TNF-alpha) was measured. RESULTS: APACHE II score was much higher, but no difference in the two groups immediately after the hospitalization. However, it increased markedly in non-survivor group, and lowered dramatically in survivor group 7 days after therapy. There was a significant difference between the two groups (P<0.01). Platelets were slightly lower in both groups immediately after the hospitalization. After three days' therapy, it increased to the normal range in the two groups. However, it progressively dropped in non-survivor group 7 days and 10 days later, and it was significantly different from survivor group (P<0.001). The white blood cell counts revealed that there was no significant difference between the two groups. The level of TNF-alpha in serum was much higher in both groups immediately after the hospitalization. After three days' therapy, it further increased and was maintained at the high level in the two groups. However, it progressively dropped in survivor group, while it remained in higher level in non-survivor group 7 days and 10 days later, which was significantly different from survivor group (both P<0.001). CONCLUSION: Refractory thrombocytopenia is sensitively responsive to poor prognosis and severity of SIRS in critical illness.