复合性挤压伤大鼠心肌酶谱及心肌组织结构变化研究  

The variation of rat's myocardial enzymes and tissue ultrastructure after combined crush injury

作　　者：郭晓明[1] 王德文[1] 刘志瑞[1] 左红艳[1] 曹桓熔[1] 王静雯[1] 任建平[1] 徐新萍[1] 王少霞[1] 刘肖[1] 彭瑞云[1] 

机构地区：[1]军事医学科学院放射与辐射医学研究所,北京100850

出　　处：《中国体视学与图像分析》2013年第2期173-181,共9页Chinese Journal of Stereology and Image Analysis

基　　金：国家科技部重点课题(2006FK130006)

摘　　要：目的探讨模拟深埋条件下挤压伤复合低氧缺水缺食(复合挤压伤)大鼠心肌酶谱及心肌组织学和超微结构的变化规律与特点。方法 Wistar大鼠125只,随机分为对照组、单纯挤压伤组、低氧缺水缺食(3缺)组和复合挤压伤组。经钳夹法作用于双后肢,置入常压低氧舱内,舱内氧浓度为10±0.1%,并禁食水,各组分别于1、3、5、7、9、11 d处死大鼠取材,检测血清肌酸激酶(CK)、乳酸脱氢酶(LDH)、谷草转氨酶(AST)水平,通过光镜和电镜观察大鼠心肌组织结构的变化,TUNEL法观察心肌细胞凋亡情况。结果单纯挤压伤组和复合性挤压伤组大鼠心肌酶谱早期均明显增高(P<0.01),以1 d时间点最为显著,此后呈逐渐下降趋势,两组相比较,复合挤压伤组增高更为明显;3缺组AST仅于7 d时一过性增高。复合挤压伤组光镜下,1 d可见心肌纤维肿胀变性、排列紊乱,3～7d加重;电镜可见心肌细胞线粒体肿胀,嵴排列紊乱、断裂,心肌细胞核染色质浓缩边移,核形不规则,部分细胞凋亡;复合挤压伤组心肌细胞凋亡率明显高于其他组。结论复合性挤压伤大鼠心肌酶谱和心肌组织结构均发生明显改变,具有全心性、速发性、进行性和不同部位损伤程度差异性特点。Objective To study the variation of rat＇ s myocardial enzymes and tissue structure after com- bined crush injury which simulated deep buried condition. Methods 125 male Wistar rats were divided into 4 groups： control group, simple crush injury group, three lack group and combined crush injurygroup. Compress the rats＇ bilateral hind limbs with tailor - made clip, The rats were put into the hypoxic compartment in which the oxygen concentration was maintained the level of 10 ± 0.1% , no food and water were given. Blood and tissue samples were collected for histology and biochemical analysis at 1, 3, 5,7, 9, 11 d. Results The serum level of myocardial enzymes increased markedly in the early period espe- cially at ld in simple crush injury group and combined crush injury group （ P 〈 0.01 ） , then decreased slowly. The level in combined crush injury group were higher than in simple crush injury group at l d AST was significantly increased in three lack group at 7 d. Myocardial structure abnormal changes were observed by light microscope and electron microscope. In combined crush injury group, myocardial fiber were swelling, degenerate arranged in disorder. The mitochondria were enlargement, contour irregulari- ties, increased spacing between the cristae and disruption of the internal in the combined crush injury group. Nuclei structure displayed an irregular envelope and Pseudo -Inclusion appeared. Nuclear chro- matin condensation and side shift. The above changes gradually aggravated from 3 d to 6.8 d. The num- ber of TUNEL - positive ceils from the combined crush injury group was significantly greater than in the sham, simple crush injury and three lack groups. Conclusion Rat＇ s creatine kinase raised up obviously, and the myocardial structure had obvious abnormal changes after combined crush injury which character- ized by high frequency, progressive and whole heart involved .

关 键 词：复合挤压伤 大鼠 心肌酶谱 心肌结构 病理变化 细胞凋亡 

分 类 号：R642[医药卫生—外科学]