高原寒区战时环境肢体枪弹伤对机体糖、蛋白质和脂肪代谢的影响  

Effects of gunshot wounds in swine's limbs on glucose,protein and fat metabolism in a wartime environment at high altitude

作　　者：殷作明[1] 李素芝[1] 胡德耀[2] 叶峰[1] 杨志焕[2] 林秀来[1] 宋俊[1] 刘良明[2] 石泉贵[1] 何代平[1] 李楠[1] 何蓉城[1] 孙克勤[1] 

机构地区：[1]西藏军区总医院全军高原战创伤救治中心,拉萨850003 [2]第三军医大学大坪医院野战外科研究所

出　　处：《西南国防医药》2010年第11期1177-1180,共4页Medical Journal of National Defending Forces in Southwest China

基　　金：军队指令性课题资助项目(01L008)

摘　　要：目的探讨高原高寒环境下肢体枪弹伤后机体糖、蛋白质、脂肪代谢的变化特点。方法将24只小型猪随机分为高原战时组(GZ)、高原平时组(GP)和平原平时组(PP),分别于伤前、伤后30min、2h、6h、12h、1d、2d、3d、5d、7d、10d、14d采静脉血,测定血糖、乳酸、游离脂肪酸和总氨基酸。同时于伤前、伤后7d和14d称量动物的体重。结果 (1)伤后30min,PP组、GP组、GZ组的血糖分别为伤前的142%、156%和179%,PP组、GP组分别于伤后1d和3d时与伤前无显著差异,而GZ组直到伤后14d仍显著高于伤前水平。(2)伤后30min,PP组、GP组、GZ组的血乳酸分别为伤前的203%、204%和233%,3组分别于伤后1d、2d和3d时与伤前无显著差异。(3)伤后6h及2h,PP组和GP组血游离脂肪酸分别降至最低点,分别为伤前值的71.3%和33.9%,均于伤后2d恢复至伤前值,至7d时达高峰,分别为伤前的138%和177%。而GZ组伤前就是GP组的267%,伤后2h为伤前的51.9%,此后逐渐升高,至1d后稳定在伤前的84%上下,始终高于GP和PP两组。(4)伤后3组总氨基酸早期升高幅度依次为GZ>GP>PP,PP组伤后12h时、GP组伤后7d时与伤前无统计学差异,GZ组伤后14d仍高于GP组。(5)伤后动物生长速度依次为GZ<GP<PP。结论高原战时枪弹伤后,机体糖代谢呈现高分解高酵解的特点,脂肪代谢呈现高分解高消耗的特点,蛋白质代谢呈现高分解低合成的特点,强度和持续时间依次为GZ>GP>PP。Objective To investigate metabolic features of glucose,protein and fat after gunshot wounds in swine＇s limbs in a wartime environment at high altitude.Methods 24 pigs were randomly divided into GZ group（n=8）,GP group （n=8） and PP group （n=8）.Pigs in GZ group were sent to high altitude （3670 m above sea level） from plain （351 m above sea level） and lived in a simulated wartime environment for 72 h until their hind limbs were wounded by gunshot.Animals in GP group were also sent to the same high altitude but lived in a normal environment for 2 w and then suffered from gunshot wounds,while those in PP group were fed under normal conditions at 16-22 ℃ in plain （351 m above sea level） and injured thereafter.Venous blood of each pig was collected at 30 min before injury and 2 h,6 h,12 h,1 d,2 d,3 d,5 d,7 d,10 d,14 d after gunshot for the measurement of blood glucose,lactic acid,free fatty acid and total amino acids content.In addition,the body weight of each pig was measured before and 7 d,14 d after injury.Results （1）Blood glucose at 30 min after injury increased 42%,56% and 79%,respectively,in PP group,GP group and GZ group compared with that before injury,and decreased to pre-injury level at 1 d and 3 d after injury in PP group and GP group,respectively.However,blood glucose level throughout 14 d after injury in GZ group was significantly higher than pre-injury level.（2）Blood lactic acid at 30 min after injury increased 103%,104% and 133%,respectively,in PP group,GP group and GZ group compared with that before injury,and decreased to pre-injury level at 1 d,2 d and 3 d after injury,respectively.（3）The plasma content of free fatty acid at 6 h and 2 h after injury decreased to the lowest level in PP group and GP group,equal to 71.3% and 33.9% of pre-injury value,respectively,and both reverted to pre-injury value at 2 d after injury.Then they reached peak value at 7 d after injury,equal to 138% and 177% of pre-injury value,respectively.In GZ group,the plasma content of free fatty

关 键 词：高原 枪弹伤 糖代谢 蛋白质代谢 脂肪代谢 

分 类 号：R594.3[医药卫生—内科学]