猪后肢枪弹伤前后肺血管容积CT与血生化指标变化趋势研究  

Study on between Biochemical Indicators of Blood and Pulmonary Artery Volume before and after Bullet Wound in the Hind Limb of Pigs

作　　者：张彦旭[1] 赵欣[1] 王小平[2] 姚立农[3] 陈广安[1] 朱佳[1] 雷学斌[1] 王亚蓉[1] 王玮[1] 

机构地区：[1]第四军医大学唐都医院放射科,陕西西安710038 [2]第四军医大学唐都医院胸外科,陕西西安710038 [3]第四军医大学唐都医院麻醉科,陕西西安710038

出　　处：《实用放射学杂志》2011年第3期446-449,474,共5页Journal of Practical Radiology

基　　金：全军医药卫生科研基金课题（06MA207）.

摘　　要：目的 采用容积CT（VCT）评价猪后肢枪弹软组织贯通伤前后肺动脉血管容积与血浆生化指标变化特点.方法 12只普通家猪,雌性,4~5个月,35~40 kg.采用81-1自动步枪,子弹7.62 mm,致伤能量508.48～520.37 J,枪击猪后肢,制成下肢软组织贯通伤-肺损伤动物模型.分别于致伤前和致伤后3 min、10 min、25 min、40 min时间点,采用VCT行胸部常规及增强扫描,利用VCT AW4.2工作站自带软件进行后处理,测量各时间点两下肺外侧基底段动脉分支容积 同时在各时间点经耳缘静脉采血,检测血浆中内皮素（ET）、皮质醇（COR）、丙二醛（MDA）、超氧化物歧化酶（SOD）、总抗氧化能力（T-AOC）的浓度变化.对照分析各时间点肺动脉血管容积与血浆生化指标的变化特点与趋势.结果 （1）致伤后3 min两肺下叶外基底段动脉容积较致伤前增加（tR=-9.98,PR＜0.05 tL=-14,PL＜0.05） 致伤后10 min较致伤前减少（tR=9.125、PR＝0.018 tL=11,PL＜0.05） 致伤后25 min、40 min两肺下叶外基底段动脉容积恢复至致伤前水平.（2）血浆ET浓度致伤后10 min升至最高点与致伤前比 较（t=9.21,P＜0.05）,血浆COR浓度致伤后10 min、25 min、40 min与致伤前比较均有统计学差异（t10 min=21,P＜0.05 t25 min=17,P＜0.05 t40 min=13,P＜0.05）,在致伤后10 min达到最高峰.（3）致伤前后血浆SOD、MDA 、T-AOC浓度在各时间点变化无统计学差异.结论致伤能量为508.48～520.37 J的国产自动步枪所致的猪后肢软组织贯通伤可导致远隔肺损伤 损伤早期两肺下叶外基底段动脉容积增加,伤后10 min血浆ET、COR达到峰值,此时肺小动脉容积明显减小 血浆MDA、SOD、T-AOC浓度无特异性变化.Objective To evaluate the corresponding changes of plasma biochemical markers and the volume of pulmonary arteries before and after penetrating bullet wound in soft tissues of hind limb of pigs by volume CT. Methods 12 pigs （ female, 4 - 5 months, 35-40 kg） were shot at the hind limb soft tissue with 81-1 automatic rifle to make the animal model of lung injury, namely the lung injury model caused by the penetrating gunshot wound of hind limb soft tissue. The released energy of 7.62 mm rifle bullet was 508.48-520.37 J. Before the shooting and 3,10,25, and 40 minutes after the shooting, the contrast-enhanced VCT scans of the chest were performed, the volume of bilateral lateral＇basal segment of lower lobe pulmonary artery and the following biochemical markers, including plasma endothelin （ET）, cortisol （COR）, malondialdehyde （MDA）, superoxide dismutase （SOD）, total antioxidant capacity （T-AOC）, were evaluated and tested. The differences between contiguous time points in the volume of interested vessel and in these markers were compared. And the analyses were conducted on the variations of pulmonary vessel volumes and plasma biochemical markers during the process of before and after shooting . Results （1）The volume of bilateral lateral basal segments of lower lobe pulmonary arteries increased at 3 minutes after（tR=-9. 98,PR〈0. 05;tL =-14, PL〈0. 05）and decreased at 10 minutes after the shooting compared with that before the shooting （tR =9. 125,PR=0. 018;tL=11, PL〈0.05）. There were no significant differences between the bilateral volume of lateral basal segments of lower lobe pulmonary vessels at 25 and 40 minutes after the shooting compared with that before bullet. （2）The plasma ET level at 10 minutes after the shooting was the highest（t=9.21,P〈0.05）. Significant differences existed in the COR concentrations between before and after injury （10, 25 and 40 rain） （t10 min=21 ,P〈0.05 ;t=5 min = 17,P〈0.05 ;t40 min= 13, P〈0.05）, the COR concentration reac

关 键 词：猪 枪弹伤 实验 体层摄影术 X线计算机 

分 类 号：R-332[医药卫生] R814.42