烧伤合并内毒素血症对肠粘膜的协同损害作用

目的 探讨在Ⅲ度体表烧伤合并小剂量内毒素注射条件下肠粘膜损伤的特点及其发生机理。方法 采用20％Ⅲ度体表烧伤合并小剂量内毒素注射的大鼠模型，动态观察了肠组织血小板激活因子（PAF）、黄嘌呤氧化酶（XO）、丙二醛（MDA）、肿瘤坏死因子（TNFa）及形态学的改变以探讨肠粘膜损害的特点和发生机理。结果 发现烧伤合并内毒素注射后早期肠粘膜即发现－系列显著的病理变化，肠组织PAF、XO、MDA在致伤后大多数时相点显著高于单因素伤组和对照组，肠组织XO、MDA分别与PAF呈显著正相关（P＜0．005）；P＜0．001），在PAF的高峰期，肠粘膜损害更明显。结论 提示烧伤合并内毒素血症对肠粘膜具有明显的协同损害效应，其发生是由于肠粘膜固有细胞激活，导致PAF、TNF产生与释放、XO活化、自由基的产生、脂质过氧化增强。

Synergistic damage of burns combined with endotoxemia on the intestinal mucosa

Objective　An animal model in which rats were subjected to 20% TBSA Ⅲ degree burns combined with injection of LPS(1mg/kg B.M.)was used for this experiment.Dynamic changes of platelet-activating factor(PAF),tumor necrosis factor(TNF),xanthine oxidase(XO) and melondialdehyde(MDA) in the intestinal tissue were measured to investigate mechanism and characteristics of the intestinal mucosal damage. The results showed a series of early pathogenic changes in the intestinl mucosa were founded,level of intestinal tissue PAF, XO and MDA level in BCEG was higher than that of any other groups at most times, XO and MDA was more positively correlated with PAF respecively after burns combined with endotoxin injection (P<0.005,P<0.001)，during the peak phase of PAF, intestinal mucosal damage was more evident. It suggests there is synergistic effect on the early intestinal mucosal damage due to activation of mucosal cells,release of PAF and TNF, activation of intestinal epithelial XO, production of free radicals and strengthenment of lipoperoxidation after burns combined with endotoxemia