胰岛素强化治疗对严重烫伤大鼠血清凋亡配体的作用  

Effect of intensive insulin therapy on apoptosis-related ligands in serum in rats with severe scald

作　　者：段红杰[1] 柴家科[1] 盛志勇[1] 姚咏明[1] 尹会男[1] 申传安[1] 吴焱秋[1] 胡泉[1] 梁黎明[1] 

机构地区：[1]解放军总医院第一附属医院全军烧伤研究所,北京100037

出　　处：《中华烧伤杂志》2009年第1期42-45,共4页Chinese Journal of Burns

基　　金：国家自然科学基金（30571919）;北京市自然科学基金（7072077）

摘　　要：目的了解大鼠严重烫伤后血清凋亡相关配体的变化及胰岛素强化治疗的作用。方法将150只Wistar大鼠随机分为假伤组、烫伤组和治疗组。烫伤组和治疗组烫伤后立即腹腔注射等渗盐水40mL／kg复苏；治疗组伤后24h皮下注射胰岛素0．25U／100g，以后每12小时注射1次，共注射5d。第1～5天的剂量分别为0．25、0．50、0．75、1．00、1．25U／100g，将大鼠血糖控制在3～6mmol／L。假伤组浸入37℃温水假伤后不进行液体复苏。于伤后1、4、7、10、14d抽取各组大鼠腹主动脉血，采用酶联免疫吸附测定法检测血清TNF-α、可溶性Fas配体（sFasL）、可溶性Fas受体（sFas）；放射免疫法检测血清胰岛素水平。结果烫伤组大鼠伤后1d血清TNF-α水平[（30．9±8．7）ng／L]即达高峰，与假伤组[（12．7±2．8）ng／L]和治疗组[（16．8±4．7）ng／L]比较，差异有统计学意义（P〈0．01），以后逐渐下降；治疗组大鼠伤后血清TNF-α水平虽然有所上升，但在伤后7d内明显低于烫伤组（P〈0．01）。烫伤组、治疗组大鼠血清sFasL分别在伤后7-14d和4～10d高于假伤组（P〈0．05），此后逐渐恢复至正常水平。伤后4-10d治疗组sFas水平明显高于烫伤组及假伤组（P〈0．05）。伤后7、10d烫伤组大鼠血清sFasL与sFas比值高于假伤组，而治疗组则在伤后7d低于烫伤组（P〈0．05），伤后14d2组均接近正常水平。烫伤组大鼠血清胰岛素水平在伤后4～10d低于假伤组（P〈0．05）。治疗组从伤后第l灭起血清胰岛素水平即显著升高，伤后4d[（327±15）μU／mL]达高峰，并显著高于假伤组[（42±15）μU／mL，P〈0．01]和烫伤组[（28±10）μU／mL，P〈0．01]，随着治疗的进行，该指标逐渐恢复到正常水平。结论胰岛素可能通过调节凋亡配体的分泌而抑制烧伤后细胞凋亡。Objective To investigate changes in apoptosis-related ligands in serum in rats with se- vere scald and the effect of intensive insulin therapy on the changes. Methods One hundred and fifty Wistar rats were randomly divided into 3 groups ： sham burn（SB） , scald （S） and treatment （T） groups. Rats in S and T groups were inflicted with 40% TBSA full-thickness burn, followed by intraperitoneal injection with 40 mL/kg of isotonic saline for resuscitation. Rats in T group were subcutaneously injected insulin in a dose of 0.25 U/100 g 24 hours after burn injury, and every 12 hours for 5 days （0.25, 0.50, 0.75, 1.00, 1.25 U/100 g each day, respectively） to control the level of blood glucose between 3 and 6 mmol/L. Rats in SB group were sham scalded at 37 ℃ without resuscitation. Blood was drawn from abdominal aorta on 1 , 4, 7, 10, 14 post burn day（PBD） for determination of serum levels of TNF-α, soluble Fas ligand（sFasL） and soluble Fas reeeptor（sFas） by enzyme-linked immunosorbent assay （ELISA） , and insulin by radioimmunity assay （RIA）. Results The serum level of TNF-α in S group peaked on 1 PBD（30.9 ±8.7）ng/L, which showed statistically significant difference when compared with that of SB and T groups （ 12.7± 2.8） ng/L, （ 16.8±4.7 ） ng/L, respectively, P 〈 0.01 ） , then lowered gradually to become similar to that of SB group on 7 PBD. The level of TNF-α in T group increased gradually, but was obviously lower than that of S group on 1, 4, 7 PBD（ P 〈0.01）. The level ofsFasLin S （on 7-14 PBD） andT（4-10 PBD） groups was significantly higher than that in SB group （ P 〈 0.05） , then lowered to normal level. The levels of sFas on 4-10 PBD in T group were obviously higher than that in S and SB group（ P 〈 0.05 ）. Ratio of sFasL to sFas in serum of S group was higher than that in SB group on 7, 10 PBD, which was higher than that in T group on 7 PBD（ P 〈 0. 05）. There was significant decrease in serum level of insulin in S group compared

关 键 词：烧伤 胰岛素 TNF相关凋亡诱导配体 

分 类 号：R644[医药卫生—外科学]