严重创伤后急性Se、GPx和MDA变化与MOF发生的相关研究  

Study on Change of Se, GPx and MDA in Blood and Relative Mechanism of Death after Severe Trauma

作　　者：王典 于晓军 张源 祁秀敏 王海鹏 杨天潼 

机构地区：[1]汕头大学医学院法医学教研室,广东汕头515041 [2]汕头大学医学院中心实验室 [3]北华大学医学院法医学教研室

出　　处：《伤残医学杂志》2005年第2期1-5,共5页Medical Journal of Trauma and Disability

基　　金：本课题得到广东省2002年科技计划项目(2002C30205)2001年度北华大学自选题资助。

摘　　要：目的:探讨严重创伤后全血硒(Se)含量及其相关酶谷甘胱肽过氧化物酶(GPx)和氧化应激产物丙二醛(MDA)的变化规律及与MOF发生的相关情况。方法:建立严重创伤家兔模(ISS=22分),检测伤后12小时、36小时、60小时、6天、9天、14天、21天全血Se含量、GPx活性、血清UDA含量。结果:伤后5天血Se含量1.48ug/ml-0.54ug/ml,较正常组2.65ug/ml-0.64ug /ml明显下降(P<0.001),伤后7天-14天为1.98±0.23ug/ml仍明显低于正常(P<0.01),3周迭2.21ug/ml-0.361ug/ml呈恢复趋势(P>0.05)。伤后12小时-7天血GPx活性2.52U/ul.min-0.59U/ul.min较正常3.58U/ul.min-0.89U/ul.min下降非常显著(P<0.001);7天后趋于正常3.26-0.44(P>0.05)。伤后3天血清MDA始升高,6天达高峰4.59nmol/ml-0.38nmol/ml,较正常的2.05-0.28升高非常显著(P<0.001),9天后维持于2.52nmol/ml-0.68nmol/ml。严重创伤组家兔有7只死亡(死亡率35%),病理学检查符合MOF表现。结论:严重创伤可引发血Se及其相关酶活性急性显著降低,相应的氧化应激产物量增高,提示这种急性微量元素缺乏可能与继发多器官衰竭(MOF)和高死亡率有关。Objective: To study the changes of Se content, its relative enzyme GPx and oxidative stress maker MDA and mechanism of death in severe traumatic rabbit. Methods: A model of severe traumatic rabbit was established (ISS=22) to measure the content of Se, the activity of GPx in whole blood and the content of MDA in serum with interval time of 12h, 36h, 6d, 14d and 21d after the trauma. Results: The blood Se content in 5 days post-trauma decreased very significantly with P<0.001 compared with the normal group, their values were respectively 1.48±0.54 ug/ml and 2,65±0.64 ug/ml. It still maintained in low level of 1.98±0.23 ug/ml with P<0.01 from 7d to 14d, and reached to normal level of 2.21±0.36 ug/ml in 3 w after trauma, P>0.05. The GPx activity dropped markedly in 7 days after trauma compared with the normal group, P<0.01, their values were 2.52±0.59 U/ul.min, 3.58±0.89 U/ul.min. Came to normal level of 3.260±0.435 U/ul.min after 7d. The MDA content of serum increased from 3d after trauma and reached to peak in the 6d with value of 4.59±0.38 nmol/ml,P<0.001 compared with normal. It maintained in 2.52±0.68 nmol/ml 9d after trauma. 7 rabbits died from 4 to 6 days after trauma with mortality of 35% in severe traumatic group. The pathological feature accorded with those of MOF in death rabbits. Conclusion: The severe trauma could lead to acute Se deficiency, lower GPx activity and higher MDA content. This mean that acute microelement deficiency caused by severe trauma may be relative with MOF, even high mortality.

关 键 词：MOF GPX 创伤后 SE 急性 相关研究 丙二醛(MDA) 严重创伤 肽过氧化物酶 微量元素缺乏 氧化应激 血清MDA 病理学检查 相关酶活性 多器官衰竭 家兔模型 相关情况 变化规律 高死亡率 ml 含量 全血硒 正常组 min 产物 下降 

分 类 号：R59[医药卫生—内科学] R459.5[医药卫生—临床医学]