快速补液对大鼠烧伤延迟复苏心肌血管内皮细胞的保护作用

目的　探讨快速补液对烧伤延迟复苏大鼠心肌微血管通透性、心肌局部内皮素 1(ET 1)和一氧化氮等细胞因子产生和分泌的改善及其心肌损害的保护作用。方法　采用大鼠 3 0 %TBSAⅢ度烧伤模型 ,动态观察烧伤延迟复苏快速补液和均匀补液后 ,大鼠心肌微血管通透性和心肌局部内皮素 1和一氧化氮等细胞因子含量及血浆中心肌肌球蛋白轻链 1浓度的改变。结果　伤后 1h ,心肌微血管通透性、心肌局部内皮素 1和一氧化氮含量即显著升高 ,6h达高峰。补液后 ,微血管通透性、心肌局部内皮素 1和一氧化氮含量均明显降低 ,快速补液组的心肌微血管通透性和心肌局部内皮素 1含量的降低幅度显著大于均匀补液组。而一氧化氮含量则两组间无明显差异。血浆中心肌肌球蛋白轻链 1的浓度变化与心肌局部内皮素 1含量改变呈正相关。结论　烧伤延迟复苏快速补液能够改善心肌血管内皮细胞功能 ,减轻心肌受损程度 ,因此 ,对烧伤延迟复苏是有益的。

The protection of rapid infusion t o delayed resuscitation burned rats on myocardium vascular endothelium cells

Objective To prob e the improvement effect of the myocardi al microvascular permeability,the level of ET 1,NO in myocardium and the protect ion of myocardium damage with rapid infu sion to delayed resuscitation burned rat s.Methods The 30% TBSA Ⅲ deg r ee burned rats were subjected to fluid r esuscitation with rapid infusion (RI gro ups) and average infusion (AI groups).Th e myocardial microvascular permeability, the level of ET 1,NO in myocardium and t he l evel of myocardial myosin light chain 1(CMLC 1) in plasma were observed.Results At 1h postburn,the m yocardial microvascular permeability,the level of ET 1 and NO was higher than pr eburn;At 6h postburn,they were the highe st level.After infusion,the myocardial m icrovascular permeability and the level of ET 1 of RI groups were faster decreas ed than AI groups,and the level of CMLC 1 in plasma were altered along with the myocardial microvascular permeability an d the level of ET 1 and NO.Conclusions The method of ra pid infusion can improve myocardial endo thelium cells function and lighten myoca rdium ischemia damage to delayed resusci tation burned rats.So,it would be an imp ortant and useful method to delayed admi tted burn patients.