“休克心”对严重烫伤大鼠早期肝肾肠损害的启动作用  

Instigating effect of shock heart on the injury to the liver , kidney and intestine at early stage of severe burn in rat

作　　者：肖荣[1] 黄跃生[1] 雷泽源[1] 阮兢[1] 张兵钱[1] 王广[1] 张琼[1] 

机构地区：[1]第三军医大学西南医院全军烧伤研究所,创伤、烧伤与复合伤国家重点实验室,重庆400038

出　　处：《中华烧伤杂志》2008年第3期175-178,共4页Chinese Journal of Burns

基　　金：国家重点基础研究发展计划（2005CB522601）;国家自然科学基金重点项目（30430680）;全军医学科学技术研究“十一五”计划专项课题（06Z033）

摘　　要：目的了解“休克心”对严重烫伤大鼠早期肝、肾、肠损害是否具有启动作用。方法将56只Wistar大鼠随机分为对照组（8只），不予烫伤；烫伤组（48只），大鼠背部造成30％TBSAⅢ度烫伤，设伤后0．5、1、0、3，0、6．0、12．0和24．0h观察时相点，每时相点8只大鼠。伤后30min按Park-land公式腹腔注射乳酸林格液（4mL·kg^-1·1％TBSA^-1）。检测大鼠肝、肾、肠血流量；动脉收缩压（SBP）、动脉舒张压（DBP）、平均动脉压（MAP）、左心室收缩压（LVSP）、左心室舒张末期压（LVEDP）、左心室压力最大上升／下降速率（±dp／dt max）；抽取各组大鼠静脉血检测其血清心肌肌钙蛋白I（cTnI）、总胆汁酸（TBA）、B：微球蛋白（β2-MG）、二胺氧化酶（DAO）含量。结果伤后1．0h烫伤组大鼠肝、。肾、肠血流量均明显降低，伤后12．0h内均呈持续下降趋势，至伤后24、0h仍显著低于对照组（P〈0．05或P〈0．01）。烫伤组大鼠伤后1、0h，LVSP和±dp／dtmax即明显下降；伤后3、0h，SBP、DBP、MAP明显下降；伤后6、0h所有心脏功能指标均降低，至伤后24、0h仍低于对照组（P〈0、01）。与对照组[（1．71±0、07）μg／L]比较，伤后0、5h烫伤组大鼠血清cTnI[（2、22±0．08）pg／L]即明显升高，伤后12．0h[（7、07±0．44）μg／L]达峰值，伤后24、0h[（4．57±0．30）μg／L]仍保持在较高水平（P〈0、01）；伤后3、0h血清TBA及伤后1．0h血清β2-MG、DAO开始明显升高，并超过对照组（P〈0．05或P〈0．01），至伤后12.0 h仍呈上升趋势。结论严重烫伤后心肌损害在时间上明显早于其他脏器，且与其他脏器损害指标和血流量呈显著相关，提示“休克心”可能是严重烫伤后早期肝、。肾、肠血流量减少和损害的启动因素之一，但还需深入研究以进一步证明。Objective To investigate the instigating effect of ＂ shock heart＂ on injury to liver , kidney and intestine at early stage of severe burn in rat. Methods Fifty-six healthy male Wistar rats were enrolled in the study and randomly divided into normal control （n = 8, without treatment ,NC） and burn （n = 48, inflicted with 30% TBSA full-thickness scald,B） groups. The rats in B group were intraperitonealy injected with Ringer＇s lactate solution （4mL·kg^-1·1%TBSA^-1） 30 minutes after burn following the Parkland formula,and they were observed at 0.5, 1.0, 3.0, 6.0, 12.0, 24.0 post-burn hour （ PBH ） , with 8 rats at each time point. The parameters concerning myocardial mechanics, including systolic blood pressure （SBP） ,diastolic blood pressure （DBP） , mean arterial pressure （MAP） , left ventricular systolic pressure （LVSP） ,left ventricular end diastolic pressure （LVEDP） , ±dp/dt max were recorded . The volume of blood flow in liver ,kidney and intestine were detected. The serum contents of cTnI, TBA, β2-MG, DAO were determined. Results ln B group ,LVSP and ± dp/dt max decreased at 1.0 PBH, SBP, DBP and MAP decreased at 3.0 PBH , all parameters of myocardial mechanics, decreased at 6.0 PBH and still lower than those in NC group at 24.0 PBH （ P 〈 0.01 ）. The volume of blood flow in liver, kidney and intestine in B group were markedly decreased at 1.0 PBH, and gradually decreased during 1.0 ～ 12.0 PBH, which were still lower than those in NC group at 24.0 PBH（ P 〈0.05 orP 〈0.01）. Compared with that in NC group （ 1.71± 0.07 μg/L） , the serum content of cTnI in B group were increased at 0.5 PBH （ 2.22 ± 0.08μg/ L, P 〈0.01） , and peaked at 12. 0 PBH（7.07±0.44 μg/L） ,and persisted at high level （4.57 ±0.30 μg/L） at 24.0PBH. The serum contents of TBA at 3.0 PBH ,62-MG at 1.0 PBH,DAO at 1.0 PBH was obviously higher than those in NC group （ P 〈 0.05 or P 〈 0.01 ） , which all showed ascending tendency during 1.0～12.0 PBH. Conclusion

关 键 词：烧伤 休克心 心肌损害 脏器血流量 

分 类 号：R644[医药卫生—外科学] R378.11[医药卫生—临床医学]