依那普利拉对严重烫伤大鼠早期心肌损害的防治作用

目的了解依那普利拉对烧伤后早期心肌损害的防治效果。方法将60只SD大鼠制成30％TBSAⅢ度烫伤模型，分为单纯烫伤组（30只，伤后常规补液）和依那普利拉组（30只，伤后立即一次性腹腔注射依那普利拉1mg／kg并行常规补液）。另取6只大鼠不致伤作为正常对照组。检测正常对照组及2组烫伤大鼠伤后1、3、6、12、24h血清心肌肌钙蛋白I（cTnI）的含量、心肌型肌酸激酶同工酶（CK—MB）的活性，并观察心肌组织病理学变化。结果（1）单纯烫伤组大鼠伤后各时相点cTnI、CK—MB均显著高于正常对照组（P〈0．01）。依那普利拉组伤后各时相点cTnI为（1．32±0．12）-（2．47±0．22）μg／L，均显著低于单纯烫伤组[（6．42±0．96）-（15．10±3．69）μg／L，P〈0．01]；其各时相点CK—MB活性为（438±68）-（5569±322）U／L，亦均低于单纯烫伤组[（2556±74）-（8047±574）U／L，P〈0．05或P〈0．01]。（2）与正常对照组比较，单纯烫伤组伤后出现心肌细胞浊肿、间质血管扩张充血、炎性细胞浸润等病理改变；依那普利拉组病变程度较之减轻。结论大鼠严重烫伤后早期心肌组织受损明显，依那普利拉能显著减轻这些损害。     

去乙酰毛花甙与依那普利拉单用及配伍应用对烫伤大鼠脏器早期损害的影响

目的 了解去乙酰毛花甙与依那普利拉单用及两药配伍应用对严重烫伤大鼠心、肝、肾、肠早期损害的影响. 方法 将40只雄性Wistar大鼠按随机数字表法分为假伤组(模拟烫伤)、烫伤对照组、去乙酰毛花甙组、依那普利拉组、去乙酰毛花甙+依那普利拉组,每组8只.大鼠麻醉后给予背部30%TBSAⅢ度烫伤,伤后30 min腹腔注射乳酸钠林格液(4 mL·kg-1·1%TBSA-1)复苏治疗.补液同时去乙酰毛花甙组静脉注射去乙酰毛花甙0.2 mg/kg;依那普利拉组静脉注射依那普利拉1 mg/kg;去乙酰毛花甙+依那普利拉组静脉注射去乙酰毛花甙及依那普利拉,剂量同前.伤后6h,以多道生理信号采集处理系统记录各组大鼠心肌力学指标;以激光多普勒血流仪记录肝、肾、肠血流量;取大鼠静脉血检测心肌肌钙蛋白I(cTnI)、总胆汁酸(TBA)、β2微球蛋白(β2-MG)、二胺氧化酶(DAO). 结果 与假伤组比较,烫伤对照组大鼠各项心肌力学指标均显著降低;肝血流量为(158±32)血流灌注单位(PU)、肾(156±46)PU、肠(119±30)PU,亦显著降低(P＜0.05);血清cTnl(5.0±0.3)μg/L、TBA(82±23)μmol/L、β-MG(2.55±0.15)mg/L、DAO(1.52±0.08)kU/L,明显高于假伤组(P＜0.05).与烫伤对照组比较,去乙酰毛花甙组和依那普利拉组心肌力学指标均有不同程度提升,肝、肾、肠血流量增加(P＜0.05),血清cTnl、TBA、β2-MG浓度和DAO活性降低(P＜0.05).去乙酰毛花甙+依那普利托组大鼠心肌力学指标全部升高,血流量分别为肝(240±49)PU、肾(239±75)PU、肠(194±55)PU,明显升高(P＜0.05),血清cTnI为(3.4±0.2)μg/L、TBA(47±8)μmol/L、β2-MG(2.01±0.16)mg/L、DAO(1.17±0.15)kU/L,均明显降低(P＜0.05). 结论 严重烫伤后早期单用去乙酰毛花甙或依那普利拉,均能改善大鼠心功能,对肝、肾、肠损害有一定防治作用,两药配伍应用可产生协同作用.     

依那普利拉减轻大鼠烧伤早期脏器损害的研究

目的 探讨依那普利拉对烧伤早期内脏损害保护作用的量效关系.方法 随机将54只SD大鼠分为烫伤组(B组)和烫伤后小剂量、中剂量和大剂量依那普利拉治疗组(E1、E2、E3组),每组12只大鼠,另取6只大鼠不致伤作为正常对照组.检测烫伤前及伤后6 h和12 h动脉血压、血管紧张素Ⅱ、尿素氮(Bun)、肌酐(Cr)和肌酸激酶(CK)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST),以及主要脏器组织病理变化.结果 B组血管紧张素Ⅱ明显升高,治疗组均明显低于B组(P均＜0.05),E2和E3组明显低于E1组;B组大鼠CK、Bun、Cr、ALT、AST均显著高于正常参考值(P均＜0.05),治疗组较B组不同程度降低,E1组下降明显(P＜0.05),各时相点基本与正常值接近;E2和E3组下降不明显,明显高于E1组;烫伤后各组动脉收缩压和舒张压均有不同程度下降,其中E2、E3组较E1组更明显,E1组较B组明显升高.结论 小剂量依那普利拉能够显著减轻严重烧伤后脏器损害的程度,但对动脉收缩压和舒张压无显著影响.     

钙分布异常对烧伤早期心肌力学障碍的影响

OBJECTIVE: To investigate the effect of abnormal Ca2+ distribution on impairment of myocardial mechanics in the early stage of thermal injury. METHODS: Calcium (Ca2+) changes were observed within subcellular distribution in situ in rat heart with calcium cytochemical probe and electron probe microanalysic technique. Meanwhile, myocardial mechanics and energy metabolic changes were investigated after thermal injury. RESULTS: The results demonstrated that levels of cytoplasmic Ca2+ in cardiomyocytes increased at 1 hour, followed by enhanced mitochondrial Ca2+ at 3 hour after burn injury. Parallel to the changes in Ca2+, there were decrease of myocardial contraction, relaxation capacity and increase of ventricular wall stiffness in burned rats. A lower level of heart energy changes was observed from 6 to 12 hours, compared with control group. CONCLUSION: The results indicate that subcellular Ca2+ abnormal distribution in myocardium caused by burn injury may be associated with rigor contraction and decreased relaxation of myocardium.     

严重烫伤大鼠早期心肌抑制对肝肾肠损害的影响

目的 了解严重烫伤大鼠早期心肌抑制对肝、肾、肠损害及血流灌注的影响.方法 将32只Wistar大鼠按随机数字表分为假伤组、普萘洛尔组、烫伤对照组和烫伤+普萘洛尔组,每组8只.各组大鼠腹腔注射10 g/L戊巴比妥钠(30 mg/kg)麻醉后,假伤组、普萘洛尔组置于37℃水中18 s致假伤,其余2组置于97℃水浴中18 s,造成30%TBSAⅢ度烫伤.伤后30 min按Parkland公式腹腔注射复方乳酸钠林格液(4 mL·kg-1·1%TBSA-1).普萘洛尔组、烫伤+普萘洛尔组补液的同时静脉注射普萘洛尔0.75 mg/kg.伤后6 h以多道生理信号采集仪检测大鼠动脉收缩压(SBP)、动脉舒张压(DBP)、平均动脉压(MAP)以及左心室收缩压(LVSP)、左心室舒张末期压(LVEDP)、左心室压力最大上升/下降速率(±dp/dt max);以激光多普勒血流仪检测肝、肾、肠血流量;同时抽取大鼠静脉血检测血清心肌肌钙蛋白I(cTnI)、总胆汁酸(TBA)、β2-微球蛋白(β2-MG)浓度和二胺氧化酶(DAO)活性.结果 普萘洛尔组除LVEDP外,SBP、DBP、MAP、LVSP、±dp/dt max均低于假伤组(P<0.05).烫伤对照组与假伤组比较,心肌力学指标均下降(P<0.05).烫伤+普萘洛尔组与烫伤对照组比较,各项心肌力学指标均明显下降(P<0.05).与假伤组比较,烫伤对照组肝、肾、肠血流量显著降低(P<0.05);与烫伤对照组比较,烫伤+普萘洛尔组肝、肾、肠血流量降低(P<0.05).烫伤对照组血清cTnI、TBA、β2-MG和DAO值分别为(4.86±0.29)μg/L、(83.6±18.2)μmol/L、(2.75±0.19)mg/L、(1.45±0.09)×103U/L,均高于假伤组[(1.73±0.09)μg/L、(24±2.4)μmol/L、(1.15±0.18)mg/L、(0.87±0.13)×103U/L,P<0.05];与烫伤对照组比较,烫伤+普萘洛尔组血清cTnI(5.95±0.42)μg/L、TBA(125.8±21.3)μmol/L、β2-MG(3.25±0.17)mg/L、DAO(1.83±0.13)×103U/L均明显升高(P<0.05).结论 严重烫伤大鼠早期心肌抑制能加剧肝、肾、肠损害,提示"休克心"可能是严重烧伤后早期肝、肾、肠血流量减少和损害的启动因素之一.     

严重烫伤大鼠早期心肌抑制对肝肾肠损害的影响

Objective To investigate the influence of myocardial inhibition on injury to liver, kid-ney and intestine and blood perfusion at early stage in rat with severe burn. Methods Thirty-two healthy male Wistar rats were enrolled in the study and randomly divided into sham scald, propranolol, scald control and scald + propranolol groups, with 8 rats in each group. After intraperitoneal injection of 10 g/L pentobar-bital sodium for anesthesia, rats of the former two groups were sham scalded in a water bath of 37 ℃ for 18 s, while the latter two groups were inflicted with 30% TBSA full-thickness scald in a 97 ℃ water bath for Parkland formula 30 rains after the injury. At the same time, rats in propranolol and scald + propranolol groups received propranolol 0.75 mg/kg intravenously. After 6 hours, parameters of myocardiac mechanics (SBP, DBP, MAP, LVSP, LVEDP, ± dp/dt max) were recorded by the multiple channel physiological signal collecting and processing system ;blood flow of liver, kidney and intestine were detected with the laser doppler flowmetry;the serum contents of cTnI, TBA, beta2-MG and DAO were determined for reflecting in-juries to the heart, liver, kidney and intestine, respectively. Results Myocardiae mechanics parameters, with the exception of LVEDP, were decreased in propranolol group as compared with those in sham group ( P <0.05). All'myoeardiac mechanics parameters in burn control group were lower than those in sham group and higher than those in burn + propranolol group (P<0.05 ). Blood flow of organs showed similar changes in above-mentioned 3 groups (P<0.05). Organ damages as shown in burn control group [cTnI (4.86+0.29) μg/L, TBA (83.6+18.2) μmol/L, β2-MG (2.75±0.19) mg/L, DAO (1.45±0.09)×103 U/L] were more serious than those in sham control group [ cTnI (1.73±0.09) μg/L, TBA (24.5± 2.4)μmoL/L, β2-MG (1.15±0.18) mg/L, DAO (0.87±0.13)×103U/L] , and less serious than those in scald + propranolol group [cTnl 5.95±0.42 μg/L, TBA 125.8±21.3 μmol/L, β2-MG 3.25 ±0.17 mg/L, DAO (1.83±0.13)×103 U/L ] ( P <0.05 ). Conclusions Propranolol can aggravate injury to the liver, kidney and intestine at early stage in rat with severe burn, suggesting that "shock heart" may be one of initial factors in lowering blood flow to the organs, thus inducing injury to them.     

严重烫伤大鼠早期心肌抑制对肝肾肠损害的影响

Objective To investigate the influence of myocardial inhibition on injury to liver, kid-ney and intestine and blood perfusion at early stage in rat with severe burn. Methods Thirty-two healthy male Wistar rats were enrolled in the study and randomly divided into sham scald, propranolol, scald control and scald + propranolol groups, with 8 rats in each group. After intraperitoneal injection of 10 g/L pentobar-bital sodium for anesthesia, rats of the former two groups were sham scalded in a water bath of 37 ℃ for 18 s, while the latter two groups were inflicted with 30% TBSA full-thickness scald in a 97 ℃ water bath for Parkland formula 30 rains after the injury. At the same time, rats in propranolol and scald + propranolol groups received propranolol 0.75 mg/kg intravenously. After 6 hours, parameters of myocardiac mechanics (SBP, DBP, MAP, LVSP, LVEDP, ± dp/dt max) were recorded by the multiple channel physiological signal collecting and processing system ;blood flow of liver, kidney and intestine were detected with the laser doppler flowmetry;the serum contents of cTnI, TBA, beta2-MG and DAO were determined for reflecting in-juries to the heart, liver, kidney and intestine, respectively. Results Myocardiae mechanics parameters, with the exception of LVEDP, were decreased in propranolol group as compared with those in sham group ( P <0.05). All'myoeardiac mechanics parameters in burn control group were lower than those in sham group and higher than those in burn + propranolol group (P<0.05 ). Blood flow of organs showed similar changes in above-mentioned 3 groups (P<0.05). Organ damages as shown in burn control group [cTnI (4.86+0.29) μg/L, TBA (83.6+18.2) μmol/L, β2-MG (2.75±0.19) mg/L, DAO (1.45±0.09)×103 U/L] were more serious than those in sham control group [ cTnI (1.73±0.09) μg/L, TBA (24.5± 2.4)μmoL/L, β2-MG (1.15±0.18) mg/L, DAO (0.87±0.13)×103U/L] , and less serious than those in scald + propranolol group [cTnl 5.95±0.42 μg/L, TBA 125.8±21.3 μmol/L, β2-MG 3.25 ±0.17 mg/L, DAO (1.83±0.13)×103 U/L ] ( P <0.05 ). Conclusions Propranolol can aggravate injury to the liver, kidney and intestine at early stage in rat with severe burn, suggesting that "shock heart" may be one of initial factors in lowering blood flow to the organs, thus inducing injury to them.     

严重烫伤大鼠早期心肌抑制对肝肾肠损害的影响

Objective To investigate the influence of myocardial inhibition on injury to liver, kid-ney and intestine and blood perfusion at early stage in rat with severe burn. Methods Thirty-two healthy male Wistar rats were enrolled in the study and randomly divided into sham scald, propranolol, scald control and scald + propranolol groups, with 8 rats in each group. After intraperitoneal injection of 10 g/L pentobar-bital sodium for anesthesia, rats of the former two groups were sham scalded in a water bath of 37 ℃ for 18 s, while the latter two groups were inflicted with 30% TBSA full-thickness scald in a 97 ℃ water bath for Parkland formula 30 rains after the injury. At the same time, rats in propranolol and scald + propranolol groups received propranolol 0.75 mg/kg intravenously. After 6 hours, parameters of myocardiac mechanics (SBP, DBP, MAP, LVSP, LVEDP, ± dp/dt max) were recorded by the multiple channel physiological signal collecting and processing system ;blood flow of liver, kidney and intestine were detected with the laser doppler flowmetry;the serum contents of cTnI, TBA, beta2-MG and DAO were determined for reflecting in-juries to the heart, liver, kidney and intestine, respectively. Results Myocardiae mechanics parameters, with the exception of LVEDP, were decreased in propranolol group as compared with those in sham group ( P <0.05). All'myoeardiac mechanics parameters in burn control group were lower than those in sham group and higher than those in burn + propranolol group (P<0.05 ). Blood flow of organs showed similar changes in above-mentioned 3 groups (P<0.05). Organ damages as shown in burn control group [cTnI (4.86+0.29) μg/L, TBA (83.6+18.2) μmol/L, β2-MG (2.75±0.19) mg/L, DAO (1.45±0.09)×103 U/L] were more serious than those in sham control group [ cTnI (1.73±0.09) μg/L, TBA (24.5± 2.4)μmoL/L, β2-MG (1.15±0.18) mg/L, DAO (0.87±0.13)×103U/L] , and less serious than those in scald + propranolol group [cTnl 5.95±0.42 μg/L, TBA 125.8±21.3 μmol/L, β2-MG 3.25 ±0.17 mg/L, DAO (1.83±0.13)×103 U/L ] ( P <0.05 ). Conclusions Propranolol can aggravate injury to the liver, kidney and intestine at early stage in rat with severe burn, suggesting that "shock heart" may be one of initial factors in lowering blood flow to the organs, thus inducing injury to them.     

严重烫伤大鼠早期心肌抑制对肝肾肠损害的影响

Objective To investigate the influence of myocardial inhibition on injury to liver, kid-ney and intestine and blood perfusion at early stage in rat with severe burn. Methods Thirty-two healthy male Wistar rats were enrolled in the study and randomly divided into sham scald, propranolol, scald control and scald + propranolol groups, with 8 rats in each group. After intraperitoneal injection of 10 g/L pentobar-bital sodium for anesthesia, rats of the former two groups were sham scalded in a water bath of 37 ℃ for 18 s, while the latter two groups were inflicted with 30% TBSA full-thickness scald in a 97 ℃ water bath for Parkland formula 30 rains after the injury. At the same time, rats in propranolol and scald + propranolol groups received propranolol 0.75 mg/kg intravenously. After 6 hours, parameters of myocardiac mechanics (SBP, DBP, MAP, LVSP, LVEDP, ± dp/dt max) were recorded by the multiple channel physiological signal collecting and processing system ;blood flow of liver, kidney and intestine were detected with the laser doppler flowmetry;the serum contents of cTnI, TBA, beta2-MG and DAO were determined for reflecting in-juries to the heart, liver, kidney and intestine, respectively. Results Myocardiae mechanics parameters, with the exception of LVEDP, were decreased in propranolol group as compared with those in sham group ( P <0.05). All'myoeardiac mechanics parameters in burn control group were lower than those in sham group and higher than those in burn + propranolol group (P<0.05 ). Blood flow of organs showed similar changes in above-mentioned 3 groups (P<0.05). Organ damages as shown in burn control group [cTnI (4.86+0.29) μg/L, TBA (83.6+18.2) μmol/L, β2-MG (2.75±0.19) mg/L, DAO (1.45±0.09)×103 U/L] were more serious than those in sham control group [ cTnI (1.73±0.09) μg/L, TBA (24.5± 2.4)μmoL/L, β2-MG (1.15±0.18) mg/L, DAO (0.87±0.13)×103U/L] , and less serious than those in scald + propranolol group [cTnl 5.95±0.42 μg/L, TBA 125.8±21.3 μmol/L, β2-MG 3.25 ±0.17 mg/L, DAO (1.83±0.13)×103 U/L ] ( P <0.05 ). Conclusions Propranolol can aggravate injury to the liver, kidney and intestine at early stage in rat with severe burn, suggesting that "shock heart" may be one of initial factors in lowering blood flow to the organs, thus inducing injury to them.     

严重烫伤大鼠早期心肌抑制对肝肾肠损害的影响

Objective To investigate the influence of myocardial inhibition on injury to liver, kid-ney and intestine and blood perfusion at early stage in rat with severe burn. Methods Thirty-two healthy male Wistar rats were enrolled in the study and randomly divided into sham scald, propranolol, scald control and scald + propranolol groups, with 8 rats in each group. After intraperitoneal injection of 10 g/L pentobar-bital sodium for anesthesia, rats of the former two groups were sham scalded in a water bath of 37 ℃ for 18 s, while the latter two groups were inflicted with 30% TBSA full-thickness scald in a 97 ℃ water bath for Parkland formula 30 rains after the injury. At the same time, rats in propranolol and scald + propranolol groups received propranolol 0.75 mg/kg intravenously. After 6 hours, parameters of myocardiac mechanics (SBP, DBP, MAP, LVSP, LVEDP, ± dp/dt max) were recorded by the multiple channel physiological signal collecting and processing system ;blood flow of liver, kidney and intestine were detected with the laser doppler flowmetry;the serum contents of cTnI, TBA, beta2-MG and DAO were determined for reflecting in-juries to the heart, liver, kidney and intestine, respectively. Results Myocardiae mechanics parameters, with the exception of LVEDP, were decreased in propranolol group as compared with those in sham group ( P <0.05). All'myoeardiac mechanics parameters in burn control group were lower than those in sham group and higher than those in burn + propranolol group (P<0.05 ). Blood flow of organs showed similar changes in above-mentioned 3 groups (P<0.05). Organ damages as shown in burn control group [cTnI (4.86+0.29) μg/L, TBA (83.6+18.2) μmol/L, β2-MG (2.75±0.19) mg/L, DAO (1.45±0.09)×103 U/L] were more serious than those in sham control group [ cTnI (1.73±0.09) μg/L, TBA (24.5± 2.4)μmoL/L, β2-MG (1.15±0.18) mg/L, DAO (0.87±0.13)×103U/L] , and less serious than those in scald + propranolol group [cTnl 5.95±0.42 μg/L, TBA 125.8±21.3 μmol/L, β2-MG 3.25 ±0.17 mg/L, DAO (1.83±0.13)×103 U/L ] ( P <0.05 ). Conclusions Propranolol can aggravate injury to the liver, kidney and intestine at early stage in rat with severe burn, suggesting that "shock heart" may be one of initial factors in lowering blood flow to the organs, thus inducing injury to them.     

伤后即行切痂对烧伤大鼠心肌损伤的防治作用

目的探讨早期一次性切痂对烧伤后心肌损伤的防治作用。方法建立30% TBSAⅢ度烧伤大鼠立即切痂模型,动物随机分为正常对照组、未切痂组和切痂组,于伤后1,3,6,12和24h 检测血浆肌钙蛋白 T(TnT)和肿瘤坏死因子(TNF)等指际。结果烧伤后3h 血浆 TnT 即显著升高,伤后6h 血浆 TNF 显著高于伤前,心肌组织中 TNF 也在伤后12h 显著升高。未切痂组与切痂组比较,伤后1～3h 未切痂组 TnT、TNF 略低于切痴组,烧伤6h后,未切痂组 TnT 显著高于切痂组,烧伤12h 后,未切痂组 TNF 显著高于切痂组。TNF 与 TnT 存在显著正相关关系。结论 TNF是引起烧伤后心肌损伤的重要因素,且与心肌损伤程度密切相关。伤后即行一次性切痂可以减少炎症介质的生成和释放,这可能是其对烧伤后并发心肌损伤具有防治作用的机理之一。     

牛磺酸对严重烧伤大鼠心肌损害的保护作用

目的　观察牛磺酸(Tau)对严重烧伤大鼠心肌损害的作用。　方法　将Wistar大鼠随机分为对照组(10只,不致伤)、烧伤组(60只)和Tau治疗组(60只)。后两组大鼠造成30%TBSAⅢ度烫伤(以下称烧伤),烧伤组伤后常规补液,Tau治疗组伤后腹腔注射Tau400mg/kg.于两组烧伤大鼠伤后1、3、6、12、24、48h检测其血浆中心肌肌钙蛋白T(cTnT)、丙二醛(MDA)的含量以及血浆、心肌组织中肿瘤坏死因子α(TNF- α)、血管紧张素Ⅱ(AngⅡ)的含量、心肌钙离子水平,用透射电镜观察心肌组织形态结构变化,并与对照组的上述指标进行比较。将烧伤组大鼠血浆TNF- α、AngⅡ检测结果分别与cTnT检测结果作相关性分析。　结果　烧伤组大鼠伤后3h起血浆cTnT水平较对照组(0.16±0. 03)μg/L显著升高(P<0. 01), 12h达峰值(6. 32±0. 41)μg/L, 48h仍显著高于对照组(P<0. 01).烧伤组伤后3—48h血浆MDA含量及心肌钙离子水平明显高于对照组(P<0. 01 );伤后6—48h血浆和心肌组织TNF- α含量显著高于对照组(P<0. 01);血浆及心肌组织中AngⅡ水平分别于伤后1—24h、3—24h明显高于对照组(P<0. 01).Tau治疗组上述指标在伤后多数时相点明显低于烧伤组(P<0. 01). 烧伤组大鼠伤后早期心肌肌丝断裂溶解、线粒体肿胀、嵴减少,Tau治疗组心肌组织接近正常。烧伤组     

牛磺酸对烫伤大鼠心肌线粒体成分和酶活性的保护作用

目的 了解牛磺酸对大鼠烫伤后心肌线粒体成分和酶活性变化的影响.方法 将120只大鼠背部脱毛后造成30%TBSA的Ⅲ度烫伤.分为烫伤组(60只),伤后腹腔注射等渗盐水(4mL·kg-1·1%TBSA-1);牛磺酸治疗组(60只),伤后腹腔注射20 g/L牛磺酸液(200 mg/kg).伤后1、3、6、12、24、48 h处死大鼠.取心肌组织检测心肌线粒体琥珀酸脱氢酶(SDH)、细胞色素c氧化酶(CCO)、超氧化物歧化酶(SOD)、Ca2+-腺苷三磷酸酶(ATPase)活性和细胞色素c、细胞色素aa3、丙二醛(MDA)、细胞质及线粒体内ca2+含量.另取10只大鼠作为对照组,模拟烫伤不予补液,1 h后处死大鼠取心肌组织检测以上指标.结果 烫伤组大鼠伤后1 h CCO活性即开始下降,伤后6、12 h下降最明显,而SDH活性在伤后6 h下降最明显,且各时相点均低于对照组;牛磺酸治疗组CCO和SDH下降不明显,伤后3、6、12 h CCO活性与烫伤组比较,差异有统计学意义(P＜0.05).伤后3、6、12、及24 h烫伤组心肌线粒体细胞色素c和细胞色素aa3均显著降低.而牛磺酸组虽然有所下降,但以上4个时相点的值均高于烫伤组(P＜0.05).烫伤组SOD活性在伤后3、6、12 h均显著性下降,ca2+ATPase活性在伤后3、6、12及24 h均有不同程度下降;而牛磺酸治疗组虽然有所下降,但以上4个时相点SOD、Ca2+-ATPase值均高于烫伤组(P＜0.05).伤后3～48 h烫伤组、牛磺酸治疗组MDA值均高于对照组(P＜0.05),但牛磺酸治疗组低于烫伤组(P＜0.05).伤后1 h烫伤组大鼠心肌线粒体中Ca2+即开始升高为13.7±1.5,伤后3、6、12、24 h分别为24.8±2.6、29.7±3.1、16.3±1.9及13.5±1.7.均高于对照组(10.7±1.6,P＜0.05);心肌细胞质中ca2+在伤后3、6、12、24 h也明显高于对照组(P＜0.05).伤后3、6、12及24 h牛磺酸治疗组大鼠心肌线粒体中ca2+浓度分别为16.8±2.8、18.7±1.9、10.5±1.8及13.3±1.7,均低于烫伤组.结论 牛磺酸对烫伤大鼠心肌线粒体成分和酶活性破坏具有保护作用,其机制与提高线粒体清除氧自由基的能力和减轻Ca2+超载有关.     

早期液体复苏对严重烫伤大鼠肝脏脂肪变性的疗效观察

目的观察早期液体复苏对严重烫伤大鼠肝脏脂肪变性的治疗效果。方法选择健康成年SD大鼠144只,随机分为4组。麻醉后假伤组背部给予30％TBSA的模拟烫伤。其余大鼠背部给予30％TBSAⅢ度烫伤,之后分为单纯烫伤组:烫伤后不补液;早期复苏组:烫伤后立即按Park- land公式用复方乳酸钠林格液进行复苏;延迟复苏组:烫伤后6 h给予液体复苏,方法同早期复苏组。分别于伤后0．5、1．0、2．0、3．0、7．0及21．0 d取各组大鼠肝脏组织,利用光学显微镜、透射电镜观察其病理变化。在相同时相点采集大鼠下腔静脉血,检测血浆总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、碱性磷酸酶(ALP)的含量。分别于采血前测量各组大鼠体重,采血后取完整肝组织称重并计算肝重:体重比值。进行统计学相关分析。结果早期复苏组大鼠肝细胞脂肪变性程度明显轻于其余两烫伤组。大鼠伤后各时相点TC、TG、ALP的含量按早期复苏组、延迟复苏组、单纯烫伤组顺序依次增高,HDL的含量依次降低。伤后大鼠肝重:体重比值升高,伤后1．0 d延迟复苏组与早期复苏组比较差异有统计学意义(P<0．05);伤后7．0 d,单纯烫伤组、延迟复苏组与早期复苏组比较,差异有统计学意义(P<0．01)。严重烫伤后肝脏脂肪变性程度与HDL含量呈显著负相关(r= -0．37,P<0．01),与ALP含量呈显著正相关(r=0．45,P<0．01),与TG含量呈显著正相关(r= 0．25,P<0．01),与肝重:体重比值呈显著正相关(r=0．44,P<0．01)。其他指标与烫伤后肝脏脂肪变性程度无相关性。结论及时有效的液体复苏可以减轻烫伤大鼠肝脏脂肪变性的严重程度,降低其发生率,有利于促进肝细胞损害的尽早恢复。     

"休克心"对严重烫伤大鼠早期肝肾肠损害的启动作用

目的 了解"休克心"对严重烫伤大鼠早期肝、肾、肠损害是否具有启动作用.方法 将56只Wistar大鼠随机分为对照组(8只),不予烫伤;烫伤组(48只),大鼠背部造成30%TBSA Ⅲ度烫伤,设伤后0.5、1.0、3.0、6.0、12.0和24.0 h观察时相点,每时相点8只大鼠.伤后30 min按Park-land公式腹腔注射乳酸林格液(4 mL·kg-1·1%TBSA-1).检测大鼠肝、肾、肠血流量;动脉收缩压(SBP)、动脉舒张压(DBP)、平均动脉压(MAP)、左心室收缩压(LVSP)、左心室舒张末期压(LVEDP)、左心室压力最大上升/下降速率(±dp/dt max);抽取各组大鼠静脉血检测其血清心肌肌钙蛋白I(cTnI)、总胆汁酸(TBA)、β2微球蛋白(β2-MG)、二胺氧化酶(DAO)含量.结果 伤后1.0 h烫伤组大鼠肝、肾、肠血流量均明显降低.伤后12.0 h内均呈持续下降趋势,至伤后24.0 h仍显著低于对照组(P＜0.05或P＜0.01).烫伤组大鼠伤后1.0 h,LVSP和±dp/dt max即明显下降;伤后3.0 h,SBP、DBP、MAP明显下降;伤后6.0 h所有心脏功能指标均降低,至伤后24.0 h仍低于对照组(P＜0.01).与对照组[(1.71±0.07)μg/L]比较,伤后0.5 h烫伤组大鼠血清cTnI[(2.22±0.08)μg/L]即明显升高,伤后12.0 h[(7.07±0.44)μg/L]达峰值,伤后24.0 h[(4.57±0.30)μg/L]仍保持在较高水平(P＜0.01);伤后3.0 h血清TBA及伤后1.0 h血清β2-MG、DAO开始明显升高,并超过对照组(P＜0.05或P＜0.01),至伤后12.0 h仍呈上升趋势.结论 严重烫伤后心肌损害在时间上明显早于其他脏器,且与其他脏器损害指标和血流量呈显著相关,提示"休克心"可能是严重烫伤后早期肝、肾、肠血流量减少和损害的启动因素之一,但还需深入研究以进一步证明.     

大黄对烫伤大鼠胃肠激素变化的影响

目的 了解严重烫伤大鼠早期血浆巾胃肠激素的变化及大黄对胃肠激素水平的影响.方法 88只Wistar大鼠随机分为正常对照组(8只)、烫伤对照组(40只,Ⅲ度烫伤后管饲蒸馏水)、烫伤治疗组(40只,Ⅲ度烫伤后管饲大黄水提液).于烫伤后6、12、24、48、72 h取大鼠腹腔静脉血,用放射免疫法检测血浆胃动素(MTL)、P物质、血管活性肽(VIP)、生长抑素(ss)的含量. 结果 (1)正常对照组大鼠MTL和P物质分别为(198±28)、(61±10)ng/L;烫伤对照组明显下降,最低值分别为(110±15)、(30±5)ng/L,而后缓慢上升,72 h达高峰,但仍未恢复正常(P<0.05);烫伤治疗组MTL和P物质下降趋势明显变缓,各时相点均高于烫伤对照组,伤后48 h已达正常水平,72 h分别为(232±32)、(73±11)ng/L,明显高于正常对照组(P<0.05).(2)止常对照组大鼠VIP和SS分别为(35±6)、(30±5)ng/L;烫伤对照组旱明显上升趋势,伤后6 h分别为(70±12)、(49±9)ng/L(P<0.01),而后缓慢下降但72 h时仍高于正常水平(P<0.05);烫伤治疗组VIP和SS上升趋势幅度较小,各时相点均低于烫伤对照组,48 h恢复至正常水平;VIP达最高值的时间推迟至伤后12 h. 结论 大黄对严重烫伤大鼠早期血浆中胃肠激素的分泌和释放有明显的调控作用.