超氧化物歧化酶、丙二醛在兔骨筋膜室综合征早期诊断中的应用  

Application of Superoxide Dismutase and Malondialdehyde in Early Diagnosis of Osteofascial Compartment Syndrome in Rabbits

作　　者：朱超[1] 杨业林[1] 王斌[1] 沈海琦[2] 

机构地区：[1]南京医科大学附属南京市江宁医院骨科,南京211100 [2]南京医科大学附属南京第一医院骨科,南京210006

出　　处：《临床误诊误治》2013年第2期62-64,共3页Clinical Misdiagnosis & Mistherapy

基　　金：南京市卫生重点科技项目基金(ZKX05007)

摘　　要：目的制作兔骨筋膜室综合征动物模型,评估超氧化物歧化酶(SOD)及血浆丙二醛(MDA)在骨筋膜室综合征早期诊断及病情评估中的作用。方法采用止血带法制作骨筋膜室综合征动物模型,15只兔作自身前后对照。用止血带紧密结扎家兔一侧小腿8 h后松开。在实验前以及松开止血带后2 h、12 h、24 h、48 h、96 h、1周和2周后连续、动态检测MDA浓度和SOD活性。同时采用Whiteside法监测小腿间室内压。实验结束后取伤侧小腿胫前肌肉和腓深神经行病理检查。结果松开止血带2 h后,血浆中MDA浓度急剧升高,SOD活性急剧降低,24 h后达到峰值或谷值。96 h后,MDA浓度和SOD活性较正常值差异仍有统计学意义(P<0.05)。松开止血带后,伤侧小腿迅速肿胀,在12 h后筋膜室内压已达到4.0 kPa以上,并在24 h后达到峰值。病理检查示肌肉和神经明显坏死呈不可逆性变化。结论 MDA及SOD的变化能客观地反映病情严重程度。当这些指标急剧升高或降低时要高度警惕骨筋膜室综合征的发生。动态、连续监测这些指标能为早期诊断及评估骨筋膜室综合征病情提供帮助。Objective To explore the efficacy of superoxide dismutase （SOD） and plasma Malondialdehyde （MDA） in the early diagnosis and pathogenetic condition evaluation of osteofascial compartment syndrome using the rabbit animal model. Methods The animal models of osteofascial compartment syndrome were produced with tourniquet method. Fifteen rabbits were enforced for self anterior-posterior comparison. Fifteen rabbits＇one side cruris were ligated with tourniquets which were loosened eight hours later. The MDA concentration and SOD activity were monitored dynamically and continuously before experiment and at 2 h, 12 h, 24 h, 48 h, 96 h, 1 week and 2 weeks after loosing the tourniquet, and intra-compartment pressure （tCP） was monitored by White- side method at the same time. The anterior tibial muscle and deep fibular nerve of injured side cruris undertook biopsy after experiment. Results Two hours after loosing the tourniquet the MDA contents increased and the SOD activity decreased rapidly. The contents of MDA were about twice more than normal; the activity of SOD was about half of normal. The MDA content and the SOD activity had significant difference when compared with those of the normal at 96 h （P 〈0.05）. The injured cruris swelled quickly af- ter loosing the tourniquet, and ICP increased over 4.0 kPa at 12 h. Twenty-four hours later, ICP reached its peak value. Pathologi- cal changes of muscle and nerve were necrosis and irreversible. Conclusion The changes of SOD and MDA can objectively refle, t the progression of disease. Clinicians should consider osteofascial compartment syndrome if the indexes increase or reduce sharply. Monitoring of the indexes dynamicly and continuously may be helpful for early diagnosis.

关 键 词：骨筋膜室综合征 超氧化物歧化酶 丙二醛 早期诊断 

分 类 号：R686[医药卫生—骨科学]