淋巴途径在烫伤大鼠肠道细菌移位中的作用  

Role of lymphatics in bacterial translocation from intestine in burn rats

作　　者：冯永强[1] 王德昌[1] 王坤[2] 冷向锋[3] 肖虎[1] 郭丹凤[4] 

机构地区：[1]山东大学附属省立医院烧伤整形科,济南250021 [2]潍坊市人民医院烧伤整形外科 [3]青岛大学医学院附属医院烧伤整形外科 [4]济南市中心医院烧伤整形外科

出　　处：《中华烧伤杂志》2011年第1期49-53,共5页Chinese Journal of Burns

摘　　要：目的了解淋巴途径在烫伤大鼠肠道细菌移位中的作用。方法制备羰花青荧光染料CM—DIL标记的大肠埃希菌菌液（数量级10 9CFU／L）。将60只成年雄性Wistar大鼠按照信封法随机分为烫伤组、假伤组，每组30只。2组大鼠经胃灌注已制备的标记菌液0．5mL后，烫伤组致30％TBSA深Ⅱ度烫伤，伤后立即行液体复苏；假伤组大鼠皮肤经25℃水浴10s模拟烫伤并同法复苏。采集2组大鼠伤后2、24、72h（每时相点10只）的肠系膜淋巴结（MLN）、肝脏、肠系膜淋巴液（MLF）、肝静脉血标本。分别采用荧光示踪法和细菌培养法检测细菌移位情况；用鲎试剂显色基质法定量测定上述4种标本中内毒素含量，并计算MLF和肝静脉血的内毒素携带量。对实验数据行t检验或单因素方差分析。结果（1）荧光示踪法检测显示活菌呈短棒状，液体标本中可见单体或两三个联体的可移动活菌；死菌呈不规则碎片状。假伤组伤后2h有少量标记菌，24h数量达高峰；烫伤组伤后2h标记菌较多，24、72h仍处于较高水平。烫伤组各种标本比较，MLN内标记菌最多，伤后24h达高峰[（5872±1976）×10 3CFU／g]，明显多于假伤组[（216＋-110）×10 3CFU／g，t=30．129，P=0．000]，72h有所减少但仍多于假伤组（t=4．323，P=0．000）；血液内标记菌最少。（2）细菌培养法检测：假伤组120份标本中，29份细菌培养呈阳性占24．2％；烫伤组120份标本中，72份培养阳性占60．0％。2组大鼠除血液标本在各时相点均未检出活菌外，其余3种标本伤后2h或24h可培养出活菌。烫伤组MLN和肝脏较其余2种组织检出更多活菌；伤后24h，该组MLN、肝脏以及MLF标本中细菌数量均明显多于假伤组（t值分别为4．353、4．354、4．965，P值均等于0．000）。（3）内毒素含量：烫伤组大鼠伤后各时相点4种标本的内毒素含量均高于假伤组，其中肝脏、MLF内�Objective To investigate the role of lymphatics in bacterial translocation from intestine of rats with burn. Methods Escherichia coli （E. coil ） labeled with chloromethylbenzamidodialkylcarbocyanine （CM-DIL） were prepared. Sixty adult male Wistar rats were randomly divided into scald group and sham injury group according to the envelope method, with 30 rats in each group. Rats in both groups were garaged with O. 5 mL fluid containing CM-DIL-labeled E. coli . Rats in scald group were inflicted with 30%TBSA deep partial-thickness scald （verified by pathological section） and resuscitated with fluid. Rats in sham injury group were sham injured by bathing in 25 ℃ water for 10 s （verified by pathological section） and also received with fluid infusion. Mesenteric lymph node （MLN）, liver, mesenteric lymph fluid （MLF）, and liver vein blood （LVB） were harvested at post injury hour （PIH） 2, 24, and 72. Bacteria transloeation was detected with fluorescent tracing technique and bacteria culture. The endotoxin content in above-mentioned four kinds of specimens was quantitatively determined with chromogenic substrate limulus amebocyte lysate. The carrying capacity of endotoxin in MLF and LVB was calculated. Data were processed with t test or one-way analysis of variance. Results （ 1 ） Living bacteria were in short-stick form, and they were seen moving in single or in doubles or triples in sample fluid. Dead bacteria were in irregular aggregates. Labeled bacteria in small amount were detected in sham injury group, their number peaked at PIH 24. A large amount of labeled bacteria were detected in scald group at PIH 2, which peaked at PIH 2d and decreased at PIH 72. The largest amount of labeled bacteria were found in MLN in scald group as compared to those in the other samples, and the number peaked at PIH 24 [ （5872 ＋- 1976） × 10 3 CFU/g] , which was obviously higher than that [ （216 ＋- 110） × 10 3 CFU/g, t =30. 129, P =0.000] in sham injury group. The number of bacteria decrea

关 键 词：烧伤 肠 淋巴 细菌移位 内毒素类 

分 类 号：R644[医药卫生—外科学]