PDF(Pubmed)
Abstract：
In preclinical studies, the protective effects of female sex hormones and the immunosuppressive effects of male sex hormones were demonstrated. However, gender-related differences in multiorgan failure and mortality in clinical trials have not been consistently explained. This study aims to investigate gender-related differences in the development and progression of sepsis using a clinically relevant ovine model of sepsis. Adult Merino male (n=7) and female (n=7) sheep were surgically prepared with multiple catheters before the study. To induce sepsis, bronchoscopy instilled methicillin-resistant Staphylococcus aureus into sheep\'s lungs. The time from the bacterial inoculation until the modified Quick Sequential Organ Failure Assessment (q-SOFA) score became positive was measured and analyzed primarily. We also compared the SOFA score between these male and female sheep over time. Survival, hemodynamic changes, the severity of pulmonary dysfunction, and microvascular hyperpermeability were also compared. The time from the onset of bacterial inoculation to the positive q-SOFA in male sheep was significantly shorter than in female sheep. Mortality was not different between these sheep (14% vs. 14%). There were no significant differences in hemodynamic changes and pulmonary function between the two groups at any time point. Similar changes in hematocrit, urine output, and fluid balance were observed between females and males. The present data indicate that the onset of multiple organ failure and progression of sepsis is faster in male sheep than in female sheep, even though the severity of cardiopulmonary function is comparable over time. Further studies are warranted to validate the above results.
摘要：
■在临床前研究中，证明了女性性激素的保护作用和男性性激素的免疫抑制作用。然而,临床试验中多器官功能衰竭和死亡率的性别相关差异尚未得到一致解释.本研究旨在使用临床相关的脓毒症绵羊模型研究脓毒症发展和进展中与性别相关的差异。在研究之前,用多个导管手术准备成年梅里诺雄性(n=7)和雌性(n=7)绵羊。为了诱发脓毒症，支气管镜检查将耐甲氧西林金黄色葡萄球菌滴入绵羊肺。测量并初步分析从细菌接种到改良的快速序贯器官衰竭评估(q-SOFA)评分变为阳性的时间。我们还比较了这些雄性和雌性绵羊随时间的SOFA得分。生存,血液动力学变化,肺功能障碍的严重程度，和微血管通透性也进行了比较。雄性绵羊从细菌接种开始到q-SOFA阳性的时间明显短于雌性绵羊。这些绵羊的死亡率没有差异(14%与14%)。两组患者在任何时间点的血流动力学改变和肺功能均无显著差异。血细胞比容也有类似的变化,尿量,观察到男女之间的液体平衡。目前的数据表明，雄性绵羊的多器官功能衰竭和败血症的进展快于雌性绵羊，尽管心肺功能的严重程度随着时间的推移是相当的。需要进一步的研究来验证上述结果。
