休克期切痂对烫伤大鼠全身和肠道局部免疫功能的影响

目的　观察休克期切痂对烫伤大鼠全身和肠道局部免疫功能的影响 ,探讨其可能的机制。　方法　选用 96只Wistar大鼠。取其中 2 4只大鼠的躯干部皮肤冻存于液氮中 ,另取 8只作正常对照组。余下 6 4只造成 30 %TBSAⅢ度烫伤后 ,随机分为A组 2 4只 ,伤后不作任何处理 ;B组 2 4只 ,伤后 2 4h腹腔注射等渗盐水 5 0ml/kg,一次性切痂后用上述冻存异体皮覆盖 ;C组 1 6只 ,伤后 72h进行处理 ,方法同B组。检测A、B组大鼠伤后 2、4、8d和C组伤后 4、8d及正常对照组大鼠的脾淋巴细胞增殖功能、血浆和肠组织白细胞介素 (IL)2水平、肠黏液分泌型免疫球蛋白A(sIgA)及肠组织中二胺氧化酶 (DAO)含量的变化。　结果　各时相点下A、B、C组大鼠脾淋巴细胞增殖功能、血浆IL 2水平、肠组织IL 2及肠黏液sIgA含量均较正常对照组减少。B组伤后 4、8d和C组伤后 8d的脾淋巴细胞增殖功能接近正常对照组 ,血浆和肠组织IL 2水平明显高于A组 (P <0.0 1)。伤后 4、8d,B组肠黏液sIgA含量分别为 (3.5 1± 2 .1 4 )、(3.0 3± 0 .95 )mg/g,C组分别为 (1 .4 0± 0 .6 4 )、(1 .5 2± 1 .2 6 )mg/g,B组较C组增加近 1倍 (P 0.0 1 )。A组伤后 4、8d肠组织DAO活性低于正常对照组和B组 (P 0.0 5)。结论　休克期切痂有助于烫伤大鼠全身和肠道

Influence of escharectomy during shock stage on the systemic and intestinal immune function in scalded rats

OBJECTIVE: To investigate the influence of escharectomy during shock stage on systemic and intestinal immune function and its mechanism in scalded rats. METHODS: Ninety-six Wistar rats were employed in the study of which 8 were used as normal control group. The donor skin from the trunk in twenty-four rats were preserved in liquid nitrogen. The other 64 rats were subjected to 30% full-thickness scalding, and they were randomly divided into A (n = 24, no treatment after scalding), B (n = 24) and C (n = 16) groups. Physiological saline was intraperitoneally injected (50 ml/kg) on the 24 post-scalding hours to the rats in the B and C groups. The rats in B group underwent escharectomy during shock stage, and the excision wounds were covered with the cryo-preserved alloskin. The rats in C group received the same treatment as in B group but at 72 post-scalding hours. The change in the proliferative ability of splenic lymphocytes, the plasma and intestinal tissue content of interleukin 2 (IL-2), the contents of sIgA in intestinal mucus, and the content of DAO in the intestinal tissue were observed on 2, 4 and 8 post burn days (PBD) in A and B groups and also on 4 and 8 PBD in C group, respectively. RESULTS: The splenocytic proliferative ability, IL-2 level in the plasma and intestinal tissue, and the sIgA content in intestinal mucus in the rats in A, B and C groups were lower than that in control group at all time points (P < 0.05). The proliferative ability of splenic lymphocytes in B group on 4 and 8 PBD and in C group on 8 PBD respectively was similar to that in control group. Whereas the IL-2 content in plasma and in intestinal tissue was higher in B and C groups than that in A group (P < 0.01). The sIgA content in intestinal mucus in B group was twice of that in C group respectively [(3.51 +/- 2.14) mg/g vs (1.40 +/- 0.64) mg/g, (3.03 +/- 0.95) mg/g vs (1.52 +/- 1.26) mg/g (P < 0.05 or P < 0.01)] on 4 and 8 PBD. The DAO activity in the intestinal tissue in A group was lower than that in control and B group (P < 0.05) on 4 and 8 PBD. CONCLUSION: Escharectomy during shock stage might be beneficial to the recovery of the systemic and intestinal immune functions in rats with scalding injury.