低分子量肝素对电烧伤大鼠血管损伤与炎症反应的影响  

Effects of low molecular weight heparin on the inflammatory response and vascular injury in rat af- ter electric burn

作　　者：蒋南红[1] 谢卫国[1] 王晖 金冬梅 谭红 赵超莉[1] 

机构地区：[1]武汉大学同仁医院暨武汉市第三医院烧伤研究所,430060 [2]病理科

出　　处：《中华烧伤杂志》2014年第2期128-133,共6页Chinese Journal of Burns

基　　金：武汉市科技局重点攻关项目（20056007071）

摘　　要：目的观察低分子量肝素（LMWH）对电烧伤大鼠血管损伤以及炎症反应的影响。方法取60只Wistar大鼠，用自制调压器和变压器制成右后肢内侧中段（电流出口）约0．5cm×0．5cm大小Ⅲ-Ⅳ度电烧伤模型，伤后即刻以20g／L磺胺嘧啶银糊剂外涂创面后暴露，每日观察创面情况。按随机数字表法将致伤后大鼠分为LMWH组与对照组，每组30只。LMWH组从致伤日起每日腹壁皮下注射LMWH1U／g，每天2次；对照组不行其他处理。伤后3、5、10d，2组分别处死10只大鼠，在创面及创周损伤组织取样约1．0cm×0．5cm并同时心脏采血，分别行HE、Masson、醛品红染色，观察病理变化及血栓形成情况，计算血栓形成率；ELISA法检测血清中TNF-α及内皮素1含量；RT-PCR法检测损伤组织巾TNF-α mRNA表达。对数据行Levene齐性检验、析因设计方差分析、LSD-t检验、SNK-q检验、FriedmanM非参数检验。结果（1）电烧伤后大鼠伤肢红肿明显，深达肌肉及骨质。与对照组比较，LMWH组大鼠各时相点红肿消退稍快，炎症反应较轻。（2）组织学观察见损伤组织坏死，大量炎性细胞浸润；组织内血管扩张，淤血及血栓形成，血管内皮细胞肿胀、坏死及脱落。2组大鼠损伤组织巾均可见血管壁结构破坏、弹力纤维断裂、内弹力膜僵直等病变。以上病变随时间推移逐渐好转，LMwH组伤后5、10d情况好于对照组。（3）LMWH组大鼠血栓形成率总体明履低于对照组（处理因素主效应F=4．921，P〈0．05）。LMWH组大鼠伤后3、10d血栓形成率分别为（0．07±0．11）％、（0．03±0．05）％，明显低于对照组的（0．16±0．15）％、（0．13±0．18）％（t值分刖为2．17、2．07，p值均小于0．05）。LMWH组大鼠伤后10d血栓形成率低于本组伤后3d（t=3．61，P〈0．05）。（4）LMWH组大鼠血清TNF-α、内皮素1含量总体明届低于对照组（处理凶素主效应Objective To observe the effects of low molecular weight heparin （LMWH） on the in- flammatary response and vascular injury in rat after electric burn. Methods A homemade regulator and transformer apparatus was used to reproduce the model of electric burn （0.5 cm×0.5 cm in size） with depth from full-thickness to full-thickness skin plus muscle and bone on the middle of the inside of right hindlimb in 60 Wistar rats. The open wounds were covered with 20 g/L sulfadiazine silver paste immediately after injury. The wound condition was observed every day. The injured rats were divided into group LMWH and control group （C） according to the random number table, with 30 rats in each group. Rats in group LMWH were given subcutaneous injection of LMWH （ 1 U/g） in abdominal wall, 2 times a day. No other treatment was given in rats in group C. On post burn day （PBD） 3, 5, and 10, 10 rats respectively of two groups were sacrificed. The damaged tissue of wound and that around the wound （ 1.0 cm × 0.5 cm in size） were ex- cised, and heart blood was obtained. The pathological changes and thrombosis in damaged tissue were ob- served with HE, Masson, and aldehyde fuchsin staining, and the thrombosis rate was calculated. Serum contents of TNF-α and endothelin-1 were determined with ELISA. The mRNA expression of TNF-α in dam- aged tissue was detected with RT-PCR. Data were processed with Levene homogeneity test, analysis of vari- ance of factorial design, LSD- t test, SNK- q test, and Friedman M nonparametric test. Results （ 1 ） The injured limb of rats was obviously swollen after electric burn, which reached deeply to the muscle and bone. Compared with those of group C, the swelling of rats subsided slightly faster and the inflammatory response was lighter in group LMWH at each time point. （2） The necrosis of damaged tissue and profuse infiltration of inflammatory cells were observed. Dilatation of blood vessels, congestion and thrombosis, and swelling, necrosis, and desquamation of vascular endot

关 键 词：烧伤 电 肝素 低分子量 肿瘤坏死因子Α 内皮素1 

分 类 号：R644[医药卫生—外科学]