烧伤延迟复苏与细胞集落刺激因子  

Levels of serum G-CSF and supplement of GM-CSF in rats sustaining delayed resuscitation after major burn

作　　者：阎汝蕴[1] 陈忠[1] 覃凤均[1] 于东宁[1] 孙永华[1] 袁润英[2] 相东[2] 李宏宇 

机构地区：[1]北京积水潭医院烧伤科,100035 [2]北京积水潭医院免疫研究室

出　　处：《中华整形烧伤外科杂志》1997年第5期368-372,共5页

摘　　要：为探讨严重烧伤延迟复苏血清粒缅胞集落刺激因子(G-CSF)的变化规律及其与感染发生、发展、预后的关系。采用大鼠30%TBSAⅢ度烧伤模型,动态观察了大鼠在立即复苏与延迟复苏两种条件下,外周血白细胞数量,血清(G-CSF)和肿瘤坏死因子-α(TNF-α)含量,中性粒细胞吞噬功能;采用大鼠30%TBSAⅢ度烧伤延迟复苏合并早期创面感染模型,动态观察应用重组粒细胞-巨噬细胞集落刺激因子(rhGM-CSF)对改善大鼠存活率的影响。结果表明:延迟复苏组动物血清 G-CSF 峰值后移,血清 G-CSF 含量,中性粒细胞吞噬功能,外周血白细胞计数均低于立即复苏组。死亡组动物表现为低血清 G-CSF,高血清 TNF-α。应用 rhOM-CSF 能够改善严重烧伤延迟复苏伴早期创面感染大鼠的存活率。提示:严重烧伤后延迟复苏并发创面脓毒症的发生与机体 G-CSF 产生减少有关,GM-CSF 应用为其开辟了一条新的治疗途径。Delayed fluid resuscitation of burn shock may lead to injection in early period following major burn injury,resulting in multiple organ failure with high mortality.The change in colony stimula- tion factors (CSFs) may play a role in developing infection.We assessed the levels of serum granulocyte colony stimulation factor (G-CSF),tumor necrosis factor-α (TNF-α),phagocytosis of neutrophil and counts of peripheral blood cells of rats with 30% TBSA full thickness burn having either immediate on delayed fluid replacement.We also evaluated the efficacy of granulocyte-macrophage colony-stimuiating factor (GM-CSF) in improving survival of rats following burn injury with a superimposed burn wound infection.The results:①A delayed rise in serum G-CSF was found in delayed resuscitation group.and the levels of serum G-CSF and phagocytosis of neutrophil were lower compared with immediate resusci tation group.②Nonsurvival group had lower levels of serum G-CSF and higher content of TNF-α com- pared with survival.③Supplement of GM-CSF could significantly improve animal survival with burn wound infection following severe burn shock.Conclusion:decrease in G-CSF production plays a role in developing fatal wound infection after severe burn shock;supplement of GM-CSF is beneficial in improv- ing survival.

关 键 词：复苏 烧伤 G-CSF 

分 类 号：R644.05[医药卫生—外科学]