甘露醇对新西兰兔严重烧伤早期血清TNF-α和IL-6的影响及其脏器功能的保护机制  

Effect of mannitol on serum tumor necrosis factor-α and interleukin-6 levels and the mechanism of its organ-protective effect in rabbits early after severe burn injury

作　　者：梁蓉[1] 荣新洲[1] 张涛[1] 沈雁[2] 戴丽冰[2] 黄粤[2] 

机构地区：[1]广州医学院附属市第一人民医院 [2]广州市红十字会医院,广东广州510180

出　　处：《南方医科大学学报》2013年第4期598-602,共5页Journal of Southern Medical University

基　　金：广东省自然科学基金(9152800001000009);广州市卫生局重点项目(2008-ZDi-08);广东省科技计划项目(2011B031300026);广州市医药科技一般引导项目(2012A011046)

摘　　要：目的探讨甘露醇补液疗法对严重烧伤新西兰兔组织器官的保护作用及其保护机制。方法将12只新西兰兔构建30%TBSA深度烧伤模型后,随机分为对照组和甘露醇组,烧伤后1 h开始补液治疗,分别于烧伤前、烧伤后1、4、8、24、48 h收集血清及48 h总尿液,用夹心酶联免疫吸附法测定血清、尿中肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)含量;生化法测定ALT、AST、GGT、CK、CK-MB、BUN和Cr含量。结果烧伤后1 h两组兔血清TNF-α和IL-6开始升高,伴随ALT、AST、GGT、CK、CK-MB、BUN和Cr升高;与对照组相比,甘露醇组兔48 h尿液TNF-α和IL-6总排泄量较高(P<0.05),血清TNF-α和IL-6水平则较低(P<0.05),ALT、AST、GGT、CK、CK-MB、BUN和Cr含量也较低(P<0.05)。结论甘露醇补液疗法可降低烧伤早期血中炎症介质TNF-α和IL-6的含量,减轻心、肝、肾的功能损害。Objective To investigate the protective effect of mannitol therapy on the vital organs and explore the underlying mechanisms in New Zealand rabbits with severe burn injury.Methods Twelve New Zealand rabbits with severe burn injury（30% of TBSA） were randomized to receive fluid resuscitation with saline（control） or mannitol therapy starting at 1 h after the injury.Serum and urine samples were collected before and at 1,4,8,24,and 48 h after the injury for detection of TNF-α,IL-6, ALT,AST,GGT,CK,CK-MB,BUN and Cr levels using sandwich ELISA.Results One hour after sever burn injury,the serum levels of TNF-α and IL-6 began to increase along with ALT,AST,GGT,CK,CK-MB,BUN and Cr levels.Compared with control group,the rabbits in mannitol group showed significantly higher 48 h urine excretion of TNF-α（145±8 vs 78±10 pg/ml,P0.05） and IL-6（93±6 vs 40±8 pg/ml,P0.05） but with lowered serum levels of TNF-α（0.62±0.02 vs 0.83±0.02 pg/ml,P0.05） and IL-6（0.45 ± 0.03 vs 0.56 ± 0.03 pg/ml,P0.05） as well as lowered serum ALT,AST,GGT,CK,CK-MB,BUN and Cr levels（P0.05）. Conclusion In rabbits with severe burn injury,mannitol therapy can decrease serum TNF-α and IL-6 levels early after the injury to ameliorate potential functional impairment of the heart,liver and kidneys.

关 键 词：液体复苏 烧伤 甘露醇 肿瘤坏死因子-α 白细胞介素-6 

分 类 号：R644[医药卫生—外科学]