模拟深埋条件下复合性挤压伤大鼠3d解除致伤后心肌组织结构损伤规律研究  

Myocardium changes after 3 d injury in a rat model of combined crush injury

作　　者：郭晓明[1,2] 王德文[2] 左红艳[2] 王少霞[2] 刘志瑞[2] 曹桓熔[2] 王静雯[2] 任建平[2] 徐新萍[2] 刘肖[2] 彭瑞云[2] 

机构地区：[1]解放军第309医院干部病房,北京100091 [2]军事医学科学院放射与辐射医学研究所,北京100850

出　　处：《军事医学》2014年第6期412-416,共5页Military Medical Sciences

基　　金：国家科技部709项目(2006FK130006)

摘　　要：目的探讨模拟深埋条件下复合性挤压伤大鼠3 d解除致伤后心肌组织结构的损伤和恢复规律与特点。方法 144只健康雄性Wistar大鼠随机分为4组,即正常对照组、单纯挤压伤组（单挤组）、低氧缺水缺食组（三缺组）和挤压伤复合低氧缺水缺食组（复合组）。经钳夹法作用于双后肢[压力为（44.1±2.9）N],置入常压低氧舱内,舱内氧浓度为（10±0.1）%,并禁食水。3 d后将大鼠从低氧舱中取出,并解除挤压,自由进食水。各组动物均于模型制作后即刻、1、3、7、14和28 d活杀取材,检测血清中肌酸激酶（CK）、乳酸脱氢酶（LDH）、天门冬氨酸转氨酶（AST）,在光镜和电镜下观察大鼠心肌组织结构变化。结果复合挤压伤致伤解除后即刻-3 d,大鼠心肌酶谱明显增高（P〈0.05,P〈0.01）,以即刻时间点增高最为明显,此后呈下降趋势,7-28 d恢复至正常水平。光镜下可见心肌纤维排列紊乱、嗜酸性变,心肌细胞肿胀,间质轻度水肿等异常改变。电镜下可见线粒体肿胀,嵴排列紊乱、断裂,心肌细胞核染色质凝集、边移、凋亡。随致伤解除后时间延长,上述病变逐渐减轻。单挤组和三缺组依次较轻。结论复合性挤压伤3 d解除时心肌酶谱明显增高,心肌组织损伤严重,致伤解除后1-28 d心肌损伤逐渐减轻,但恢复较缓慢。Objective To observe the myocardium changes after combined crush injury.Methods 144 rats were randomly assigned to 4 groups：control group,simple crush injury group,three-lack group and combined crush injury group.The rats＇ bilateral hindlimbs of crush injury group were compressed with custom-made clips [pressure（44.1 ± 2.9）N]and the rats were put into a hypoxic compartment [oxygen concentration（10 ± 0.1）%]for 72 h without food or water.After 72 h the rats were moved to a normoxic environment,where the clips were removed（decompression） and food and water were freely accessible.Blood and myocardium samples were collected for biochemical,HE and ultrastructure analysis at each of days 0,1,3,7,14 and 28 after decompression.Results In combined crush injury group,the myocardial enzymes were increased at 0 day,1 d and 3 d obviously（P〈0.05,P〈0.01）.The myocardial enzymes were highest at0 day,then decreased at the following days,and returned to normal levels at 7- 28 d.Myocardial fibers derangement,eosinophilic change,myocardial cell swelling,interstitial edema and other abnormal changes were observed under light microscope.Under electron microscopy,the hearts of combined crush injury group revealed abnormal mitochondria and nuclei structure.The mitochondria were swollen,even ruptured,cristae were irregularity.Nuclear chromatin was condensated and side shift.The injury was gradually reduced.The injury of simple crush injury group and three-lack group were lighter.Conclusions The findings suggest that abnormal myocardium injury was induced in rats after simulated combined crush injury and decompression and were slow to resolve.

关 键 词：复合性挤压伤 大鼠 心脏 超微结构 

分 类 号：R642[医药卫生—外科学]