乌司他丁对严重烧伤犬早期血浆容量及脏器血管通透性的影响

目的观察烧伤休克期早期给予乌司他丁对全身血浆容量和脏器血管通透性的影响。方法采用成年Beagle犬35%TBSAⅢ度模型,随机分为两组:(1)对照组(C组):烧伤后不予治疗;(2)乌司他丁组(U组):伤后半小时按10 000 U/kg静脉注射乌司他丁。于烧伤前和烧伤后2、4、68、h抽血检测血细胞比容(HCT)、肿瘤坏死因子-α(TNF-α)和丙二醛(MDA)的含量;用吲哚菁绿法测定各时间点血浆容量。8 h后处死动物,用伊文思蓝法测脏器血管通透性及干湿重法测脏器含水率。结果两组HCT、TNF-α和MDA伤后均升高,但U组升高幅度明显小于C组,两组之间有显著统计学差异(P<0.01或P<0.05);两组血浆容量伤后均下降,但U组自伤后2 h开始,血浆容量明显高于C组(P<0.01)[U组4 h和8 h分别为(515±25)ml和(491±29)ml,而C组为(432±18)ml和(366±37)ml];伤后8 h U组肝、脾、肾、空肠的伊文思蓝(EB)含量及含水率均明显低于C组(P<0.01或P<0.05)。结论烧伤休克期早期给予乌司他丁能有效缓解伤后循环血量的快速丢失,降低远隔脏器的血管通透性,减轻脏器损害及水肿程度。

The effects of ulinastatin on the plasma volume and organ vasopermeability in dogs with severe burn during early stage

Objective To observe the effects of ulinastatin used during early stage of burn shock on the plasma volume and organ vasopermeability.Methods Beagle dogs with 35% TBSA third degree were used and randomly divided into 2 groups:(1) control group(CG): No treatment was given after burn;(2) ulinastatin group(UG): Ulinastatin was given in a dose of 10000U/kg through intravenous injection 30 minutes after burn.Before burn and at 2h,4h,6h,8h postburn,Blood samples were taken to determine HCT,TNF-α and MDA.Plasma volume was determined by method of indocyanine green(ICG) method at each time.At the end of 8-hour experiment,animals were sacrificed to collect organs for determining vasopermeability by Evans Blue method,and assessment of water content of organs by Dry/wet Weight method.Results HCT,TNF-α and MDA rose in both groups,while in UG the rising extent was less than that in CG.There was statistic difference between the two groups(P<0.01 or P<0.05).From 2h after burn,plasma volume in UG sustained much higher than that in CG,which decreased in both groups similarly(P<0.01 or P<0.05)(plasma volume at 4h and 8h PB in UG was 515±25ml and 491±29ml respectively,while it in CG was 432±18ml and 366±37ml).Both EB content and water content of liver,spleen,kidney and jejunum in UG were much lower than that in CG at 8h PB(P<0.01 or P<0.05).Conclusion Ulinastatin used in early shock stage after burn can attenuate the rapid loss of circulation volume,decrease distant organ vasopermeability and alleviate organ damage and tissue edema.