甘精胰岛素对延迟复苏烧伤大鼠心脏肾脏损伤的影响  

Effect of insulin glargine on heart and kidney damage in burned rats with delayed fluid resuscitation

作　　者：喻翔[1] 孔豫苏[1] 李伟人[1] 鲁加祥[1] 李嘉琥[1] 

机构地区：[1]贵阳医学院附属医院烧伤整形科,贵州贵阳550004

出　　处：《中国急救医学》2015年第8期745-748,共4页Chinese Journal of Critical Care Medicine

基　　金：贵州省卫生厅科学技术基金（gzwkj2011-1-022）

摘　　要：目的：探讨甘精胰岛素对延迟复苏烧伤大鼠心脏、肾脏组织的保护作用。方法24只雄性SD大鼠按随机数字表法分为假伤组、烧伤对照组、烧伤＋胰岛素组，每组各8只。假伤组浸入37℃温水中15 s模拟烫伤。烧伤对照组、烧伤＋胰岛素组（95．0±0．5）℃热水中15 s制作烧伤总面积（ TBSA）30％、Ⅲ度烫伤模型，伤后6 h腹腔注射生理盐水（40 mL／kg）。烧伤＋胰岛素组于伤后2 h皮下注射甘精胰岛素[1．0 U／（kg· d）]，烧伤对照组同法注射等量生理盐水。烧伤各组于伤后24 h采集腹主动脉血及心脏、肾脏组织标本。采用分光光度法测定血糖、乳酸脱氢酶（LDH）、α－羟丁酸脱氢酶（α－HBDH）、肌酸激酶（CK）、尿素氮（BUN）、肌酐（Cr）、丙二醛（MDA）、黄嘌呤氧化酶（XO）、髓过氧化物酶（MPO）、超氧化物歧化酶1（SOD1）、过氧化氢酶（ CAT）、谷胱甘肽过氧化物酶（ GPx）、总抗氧化能力（ T－AOC）；免疫抑制法测定肌酸激酶同工酶（ CK－MB）。结果①烧伤对照组LDH、α－HBDH、CK、CK－MB、BUN、Cr均显著高于假伤组（P＜0．05）；与烧伤对照组比较，烧伤＋胰岛素组LDH、α－HBDH、CK、CK－MB、BUN、Cr均显著降低（P＜0．05）。②与假伤组比较，烧伤对照组心脏、肾脏组织的MDA、XO、MPO均显著升高（P＜0．05），SOD1、CAT、GPx、T－AOC均显著降低（P＜0．05）；与烧伤对照组比较，烧伤＋胰岛素组心脏、肾脏组织的MDA、XO、MPO均显著降低（P＜0．05），SOD1、CAT、GPx、T－AOC均显著升高（ P＜0．05）。③烧伤对照组、烧伤＋胰岛素组血糖水平均显著高于假伤组，而烧伤＋胰岛素组显著低于烧伤对照组（ P＜0．05）。结论甘精胰岛素对延迟复苏烧伤大鼠心脏、肾脏组织的保护作用可能与早期血糖控制、减轻组织脂质过氧化损伤有关。Objective To investigate the protective effect of insulin glargine against heart and kidney damage in burned rats with delayed fluid resuscitation.Methods Twenty-four male Sprague-Dawley （ SD） rats were randomly divided into three groups with 8 rats in each group：sham burn group, burn control group and burn plus insulin group.The sham burn group was immersed into 37 ℃ warm water for 15 seconds to simulate the burn process.The burn control group and burn plus insulin group were immersed into （95 ±0.5）℃ hot water for 15 seconds to make a rat model of 30% total burn surface area （ TBSA） ,Ⅲ degree burn injury rats received an intraperitoneal injection of physiological saline （40 mL/kg） at 6 h after burn.Insulin glargine [1.0 U/（kg· d）] was administered subcutaneously at 2 h postburn in burn plus insulingroup, and subcutaneous injection of the same volume physiological saline in the burn control group.Rats were sacrificed 24 h after burn, abdominal aorta blood was gathered and blood glucose, lactate dehydrogenase （ LDH ）, α-hydroxybutyrate dehydrogenase （α-HBDH） , creatine kinase （ CK） , blood urea nitrogen（ BUN） , creatinine （ Cr） were analysised.Oxidation and antioxidation parameters in heart and kidney obtained from rats, such as malondialdehyde （MDA）, xanthine oxidase （XO）, myeloperoxidase （MPO）, superoxide dismutase 1 （SOD1）, catalase （CAT）, glutathion peroxidase （GPx） and the total antioxidant capacity （T-AOC）, these parameters were detected by spectrophotometry.Creatine kinase MB （ CK-MB） was determined by immunosuppression.Results （1） Compared with the sham burn group, LDH, α-HBDH, CK, CK-MB, BUN, Cr were significantly higher in the burn control group （P〈0.05）.In the burn plus insulin group, LDH,α-HBDH, CK, CK-MB, BUN, Cr were significantly lower in comparison with the burn control group （P〈0.05）.（2） Compared with the sham burn group, the burn control group MDA, XO, MPO in the heart and kidney tissues were

关 键 词：烧伤 延迟复苏 甘精胰岛素 应激性高血糖 氧化应激 

分 类 号：R587.1[医药卫生—内分泌]