极化液和丙酮酸钠联合治疗严重烫伤多器官功能不全综合征大鼠实验研究  

Effect of GIK Combined with Sodium Pyruvate in Treatment of Rats with Multiple Organ Dysfunction Syndrome Induced by Severe Scald

作　　者：钟莹 王占科[1,2] 周方强 胡添 王庆莅 郭靓 ZHONG Ying;WANG Zhan-ke;ZHOU Fang-qiang;HU Tian;WANG Qing-li;GUO Liang(Medical College of Nanchang University,Nanchang 343000,China;Department of Clinical Laboratory,94 Hospital of PLA,Nanchang 330002,China;Fresenius Medical Care Dialysis Center at Chicago,Chicago 60008,American;Graduate School of Nankai University,Tianjin 300071,China)

机构地区：[1]南昌大学医学院,南昌330006 [2]解放军94医院检验科,南昌330002 [3]Fresenius Medical Care Dialysis Center at Chicago,USA Chicago 60008 [4]南开大学研究生院,天津300071

出　　处：《解放军医药杂志》2018年第7期1-6,共6页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：江西省卫计委课题(20173025)

摘　　要：目的观察极化液和丙酮酸钠联合治疗严重烫伤多器官功能不全综合征(MODS)大鼠效果。方法 80只SD清洁级30%TBSAⅢ度烫伤MODS大鼠按随机数字表法分为极化液治疗组(GIK组)、丙酮酸钠治疗组(SP组)、极化液和丙酮酸钠联合治疗组(GIK+SP组)和对照组,每组20只,观察4组伤前、伤后1、3、5及7 d血糖(GLU)、乳酸(LA)、丙酮酸(PA)、可溶性髓样细胞触发蛋白1(s TREM-1)、高迁移率族蛋白B1(HMGB-1)和丙二醛(MDA)、超氧化物歧化酶(SOD)水平变化情况。结果 4组伤后各时点GLU、LA、LA/PA、s TREM-1、HMGB-1以及MDA水平均高于伤前(P<0.01),SOD水平均低于伤前(P<0.01);GIK组、SP组和GIK+SP组伤后各时点GLU、LA、PA、LA/PA、s TREM-1、HMGB-l及MDA水平低于对照组,PA、SOD水平均高于对照组(P<0.01);GIK+SP组伤后各时点GLU、LA、LA/PA、s TREM-1和HMGB-1以及MDA水平均低于GIK组和SP组,SOD均水平高于GIK组和SP组(P<0.01)。结论严重烫伤MODS大鼠存在高血糖、高乳酸血症、过度炎症反应和氧自由基损伤,极化液和丙酮酸钠具有改善高乳酸血症,降低LA/PA比值以及抗炎和抗氧化作用,且联合治疗比单独治疗效果更好,可作为防治严重烫伤后MODS重要措施。Objective To observe effect of combination of glucose-insulin-potassium （GIK） combined with Sodium Pyruvate in treatment of rats with muhiple organ dysfunction syndrome （MODS） induced by severe scald. Methods A total of 80 cleaning 30% total body surface area （TBSA） Ⅲ scald SD MODS rats were divided into GIK treatment group （ GIK group, n = 20）, Sodium Pyruvate treatment group （ SP group, n = 20）, GIK combined with Sodium Pyruvate treatment group （ group GIK ＋ SP, n = 20） and control group （ n = 20） according to random digits table method. Changes of blood glucose （GLU）, lactic acid （LA）, Pyruvate （PA）, soluble myeloid cells trigger protein 1 （sTREM-1）, high mobility group protein B1 （HMGB-1） and malondialdehyde （MDA）, superoxide dismutase （SOD） levels before injury, 1d, 3 d, 5 d and 7 d after injury were observed. Results At all time points after injury, GLU, LA, LA/PA, sTREM- 1, HMGB-1, and MDA levels were significantly higher （ P 〈 0.01 ） , while SOD levels were significantly lower than those before injury in 4 groups （P 〈 0.01 ）. Compared with those in control group, GLU, LA, PA, LA/PA, sTREM-1, HMGB-1, and MDA levels were significantly lower, while PA and SOD levels were significantly higher in GIK, PA and GIK ＋ PA groups at all time points after injury （P 〈 0.01 ）. In group GIK ＋ SP, GLU, LA, LA/PA, sTREM-1, HMGB-1, and MDA levels were significantly lower, while SOD levels were significantly higher at all time points after injury cornpared with those in GIK and SP groups （P 〈 0.01 ）. Conclusion MODS rats induced by severe scald have hyperglycemia, hyperlactacidemia, excessive inflammatory reaction and oxygen radicals injury. GIK and Sodium Pyruvate may improve hyperlactacidemia, reduce LA/PA ratio, anti-inflammatory and antioxidant effects, and combination therapy may achieve better effect than that by single therapy, and therefore GIK combined with Sodium Pyruvate may be uses as an important method in treatment of MODS

关 键 词：烫伤 极化液 丙酮酸钠 多器官功能不全综合征 大鼠 SPRAGUE-DAWLEY 炎症 氧化应激 

分 类 号：R-332[医药卫生] R641