高原寒区战时环境肢体枪弹伤对机体糖、蛋白质和脂肪代谢的影响

目的 探讨高原高寒环境下肢体枪弹伤后机体糖、蛋白质、脂肪代谢的变化特点.方法 将24只小型猪随机分为高原战时组（GZ）、高原平时组（GP）和平原平时组（PP）,分别于伤前、伤后30 min、2 h、6 h、12 h、1 d、2 d、3 d、5 d、7 d、10 d、14 d采静脉血,测定血糖、乳酸、游离脂肪酸和总氨基酸.同时于伤前、伤后7 d和14 d称量动物的体重.结果 （1）伤后30 min,PP组、GP组、GZ组的血糖分别为伤前的142%、156%和179%,PP组、GP组分别于伤后1 d和3 d时与伤前无显著差异,而GZ组直到伤后14 d仍显著高于伤前水平.（2）伤后30 min,PP组、GP组、GZ组的血乳酸分别为伤前的203%、204%和233%,3组分别于伤后1 d、2 d和3 d时与伤前无显著差异.（3）伤后6 h及2 h,PP组和GP组血游离脂肪酸分别降至最低点,分别为伤前值的71.3%和33.9%,均于伤后2 d恢复至伤前值,至7 d时达高峰,分别为伤前的138%和177%.而GZ组伤前就是GP组的267%,伤后2 h为伤前的51.9%,此后逐渐升高,至1 d后稳定在伤前的84%上下,始终高于GP和PP两组.（4）伤后3组总氨基酸早期升高幅度依次为GZ〉GP〉PP,PP组伤后12 h时、GP组伤后7 d时与伤前无统计学差异,GZ组伤后14 d仍高于GP组.（5）伤后动物生长速度依次为GZ〈GP〈PP.结论 高原战时枪弹伤后,机体糖代谢呈现高分解高酵解的特点,脂肪代谢呈现高分解高消耗的特点,蛋白质代谢呈现高分解低合成的特点,强度和持续时间依次为GZ〉GP〉PP.

Effects of gunshot wounds in swine's limbs on glucose,protein and fat metabolism in a wartime environment at high altitude

Objective To investigate metabolic features of glucose,protein and fat after gunshot wounds in swine＇s limbs in a wartime environment at high altitude.Methods 24 pigs were randomly divided into GZ group（n=8）,GP group （n=8） and PP group （n=8）.Pigs in GZ group were sent to high altitude （3670 m above sea level） from plain （351 m above sea level） and lived in a simulated wartime environment for 72 h until their hind limbs were wounded by gunshot.Animals in GP group were also sent to the same high altitude but lived in a normal environment for 2 w and then suffered from gunshot wounds,while those in PP group were fed under normal conditions at 16-22 ℃ in plain （351 m above sea level） and injured thereafter.Venous blood of each pig was collected at 30 min before injury and 2 h,6 h,12 h,1 d,2 d,3 d,5 d,7 d,10 d,14 d after gunshot for the measurement of blood glucose,lactic acid,free fatty acid and total amino acids content.In addition,the body weight of each pig was measured before and 7 d,14 d after injury.Results （1）Blood glucose at 30 min after injury increased 42%,56% and 79%,respectively,in PP group,GP group and GZ group compared with that before injury,and decreased to pre-injury level at 1 d and 3 d after injury in PP group and GP group,respectively.However,blood glucose level throughout 14 d after injury in GZ group was significantly higher than pre-injury level.（2）Blood lactic acid at 30 min after injury increased 103%,104% and 133%,respectively,in PP group,GP group and GZ group compared with that before injury,and decreased to pre-injury level at 1 d,2 d and 3 d after injury,respectively.（3）The plasma content of free fatty acid at 6 h and 2 h after injury decreased to the lowest level in PP group and GP group,equal to 71.3% and 33.9% of pre-injury value,respectively,and both reverted to pre-injury value at 2 d after injury.Then they reached peak value at 7 d after injury,equal to 138% and 177% of pre-injury value,respectively.In GZ group,the plasma content of free fatty acid before injury was 167% higher than that in GP group.It decreased to 51.9% of pre-injury value at 2 h after injury,and increased gradually until being stable at around 84% of pre-injury level 1 d after injury.Since then,it was higher than that in GP group and PP group all the time.（4） The rank order of early increased extent of total amino acids after injury was GZ group〉GP group〉PP group.Then it decreased to a level that showed no statistically significant difference with pre-injury level at 12 h and 7 d after injury in PP group and GP group,respectively,but the plasma content of total amino acids in GZ group was still higher than that in GP group at 14 d after injury.（5）The rank order of growth velocity after injury was GZ group〈GP group〈PP group.Conclusion In a wartime environment at high altitude,the glycometabolism presents a feature of high decomposition and high zymolysis,fat metabolism presents a feature of high decomposition and high consumption,and protein metabolism presents a feature of high decomposition and low composition after gunshot wounds,.The rank order of the intensity and duration of these features is GZ group〉GP group〉PP group.