家兔氢氟酸烧伤心肌损害的实验研究

目的　研究氢氟酸烧伤对心肌的影响 ,提高对氢氟酸导致氟中毒的认识。　方法　采用新西兰白兔 2 %TBSAⅢ度氢氟酸烧伤模型 ,观察各时相点心肌和相关酶谱指标的改变 ,以及病理形态学变化。　结果　 ( 1)伤后心肌各项酶含量较伤前明显增高 (P <0 .0 1)。 ( 2 )血清心肌酶含量增高峰值均在 48h以内出现。各时相点心肌酶谱含量的差异均有非常显著性意义 (P <0 0 1)。( 3)血清心肌酶含量以CPK增幅最大 ,增加了 97.5 %。而LDH、AST、CK -MB分别增加了 81.9%、76 .1%和 6 0 .3%。 ( 4)病理形态学检查发现 ,光镜下见心肌纤维颗粒变性、灶性坏死 ,心肌间质出血 ,并伴有中性粒细胞、淋巴细胞浸润。电镜观察心肌细胞内肌原纤维减少或消失 ,细胞水肿严重 ,线粒体肿胀、嵴消失 ,血管内皮细胞肿胀 ,电子密度极低 ,呈大泡状 ,肌细胞核变形。　结论　氢氟酸烧伤后对心肌有一定程度损害 ,心肌和心肌相关酶谱含量的改变 ,反映了氢氟酸致伤后的心肌损伤程度 ,在抢救氢氟酸烧伤、氟中毒时应监测心肌酶谱及心电图等指标 ,注意保护心脏的功能

An experimental study of myocardial injury by hydrofluoric acid burn in rabbits

OBJECTIVE: To investigate the myocardial injury by hydrofluoric acid in burned rabbits METHODS: New Zealand white rabbits were injured with 2% TBSA III degree skin burn on the back by hydrofluoric acid. The blood and tissue samples were taken from the rabbit after injury for the detection of myocardial and related enzymes and the pathomorphological examination. RESULTS: (1) Postburn myocardial enzymes increased significantly compared to those before burn (P < 0.01). (2) All the myocardial enzymes reached their peak levels within 48 postburn hours and were higher than those before burn (P < 0.01). (3) Among all the enzymes, CPK increased by 97.5% and those of LDH, AST and CK-MB by 81.9%, 76.1% and 60.3%, respectively. (4) Pathomorphological findings with LM were the granular degeneration and focal necrosis of myocardial fibers, interstitial hemorrhage of myocardium accompanied with neutrophil and lymphocyte infiltration. Ultrastructural changes included myofibril decrease or even disappearing, severe cellular and mitochondrial swelling, disappearing of mitochondrial crista, endothelial swelling, decrease of electronic density with the exhibiting of bulla and deformation of myocardial cellular nucleus. CONCLUSION: Myocardial function could be damaged after hydrofluoric acid burn. Therefore, special attention should be paid to the protection of cardiac function after hydrofluoric acid burn by strengthening the monitoring of myocardial enzymes and ECG, etc.