富氢盐水对严重烫伤延迟复苏大鼠肠道损伤的影响

目的:探讨富氢盐水对严重烫伤延迟复苏大鼠肠道损伤的影响及机制。方法:48只SD大鼠随机分成假烫伤组(S组)、烫伤+0.9%氯化钠注射液处理组(B+N组)、烫伤+富氢盐水处理组(B+H组)、烫伤+维生素C处理组(B+C组),各12只。制作大鼠背部全层皮肤烫伤30%TBSA模型,伤后6 h按Parkland公式用林格液补液复苏。在伤后6、18、30、42 h各组大鼠腹腔分别注射0.9%氯化钠注射液(5 ml/kg)、0.9%氯化钠注射液(5 ml/kg)、富氢盐水(5 ml/kg)、维生素C(9 ml/kg)(250mg/kg)。观察伤后24、48 h的肠道病理改变,并检测肠道组织中丙二醛、二胺氧化酶、白细胞介素1β的变化及肠绒毛上皮细胞凋亡率。结果:与B+N组相比,B+C组和B+H组24、48 h时相点大鼠肠道病理形态改变均显著减轻(P0.01);二胺氧化酶均显著升高(P0.01);而丙二醛、白细胞介素1β、肠黏膜上皮细胞凋亡率均显著降低(P0.01)。结论:富氢盐水可有效减轻严重烫伤延迟复苏肠道的缺血-再灌注损伤,其保护作用可能与富氢盐水减轻再灌注损伤引起的氧化应激反应、炎性因子介导的炎症反应以及抑制肠道上皮细胞凋亡等机制有关。

Effect of hydrogen-rich saline on intestine damage in scalded rats following delayed resuscitation

Objective ：To investigate the effect and mechanism of hydrogen-rich saline on rat intestine damage after severe burn. Methods ： Forty eight rats were divided into four groups ： sham plus normal saline （S） group, burn injury plus normal saline （ B ＋ N ） group, burn injury plus hydrogen-rich saline （B ＋ H）group, and burn injury plus vitamin C （B ＋ C）group. Each group contains 12 rats. Animals were subjected to full-thickness burn wound（ 30% total body surface area） using boiling water, except the rats in sham group which were treated with room-temperature water. Lactated Ringer＇s solution was given at 6 h after injury according to Parkland formula. The rats in B ＋ H group were received 5 ml/kg of hydrogen-rich saline, others in S and B ＋ N groups were received the same amount of saline,and the rats in B ＋ C group were treated with 9 ml/kg （250 mg/kg） of vitamin C in saline at 6,18,30,42 hour after scald respectively. The intestinal pathological changes at 24 and 48 h after scald was investigated. The changes of malondialdehyde, diamine oxidase, interleukin-1β and apoptosis rate of intestinal epithelial cells were determined. Results ： Compared with B ＋ N group, in B ＋ C and B ＋ H groups, the intestinal pathological changes were significantly reduced, diamine oxidase activity was increased significantly（ P 〈0.01 ）, and malondialdehyde, interleukin-l[5 levels and apoptosis rate of intestinal epithelial cells were significantly reduced （P 〈 O. 01 ）. Conclusions：Hydrogen-rich saline can protect the small intestine against ischemia and reperfusion injury after severe burn, its mechanisms include relief of oxidative stress, inflammatory factor-mediated inflammatory response and inhibition of intestinal epithelial cell apoptosis.