基于相同伤情的小鼠平原和高原严重冲击伤致伤参数研究  

Study on injury parameters of severe blast injury in mice at plain and plateau based on equivalent trauma

作　　者：张雷廷 余静 王海燕 李森 刘可 夏雨 廖志康 李遂焰[2] 严军 Zhang Leiting;Yu Jing;Wang Haiyan;Li Sen;Liu Ke;Xia Yu;Liao Zhikang;Li Suiyan;Yan Jun(Department of Special War Wound,State Key Laboratory of Trauma,Burns and Combined Injury,Institute of Surgery Research,Daping Hospital,Army Medical University,Chongqing 400042,China;School of Life Science and Engineering,Southwest Jiaotong University,Chengdu 610031,Sichuan,China;Department of Military Traffic Medicine,State Key Laboratory of Trauma,Burns and Combined Injury,Institute of Surgery Research,Daping Hospital,Army Medical University,Chongqing 400042,China)

机构地区：[1]陆军军医大学大坪医院野战外科研究部特殊环境战伤防治研究室,创伤、烧伤与复合伤国家重点实验室,重庆400042 [2]西南交通大学生命科学与工程学院,四川成都610031 [3]陆军军医大学大坪医院野战外科研究部军事交通伤防治研究室,创伤、烧伤与复合伤国家重点实验室,重庆400042

出　　处：《中华危重病急救医学》2022年第10期1076-1081,共6页Chinese Critical Care Medicine

基　　金：教育部极端环境医学重点实验室开放课题(PR-KL2020GY004)。

摘　　要：目的探讨制备可相互转换的相同伤情平原和高原冲击伤动物模型致伤参数。方法157只C57BL/6雄性小鼠按随机数字表法分为平原对照组(8只)、平原致伤组(77只)、高原对照组(8只)和高原致伤组(64只),其中高原对照组和高原致伤组预先置于动物实验低压氧舱中模拟4000 m高原环境习服5 d。将平原致伤组和高原致伤组小鼠置于Ⅰ型生物激波管内,选择不同驱动段压强致伤,以72 h内死亡率达70%左右为标准,确定平原致伤组和高原致伤组的驱动段压强,利用该参数进行平原和模拟4000 m高原制备小鼠严重冲击伤模型,通过大体解剖、肺湿/干质量比值(W/D)、苏木素-伊红(HE)染色和肺组织损伤评分比较各组小鼠致伤24 h后肺病理变化,验证各组伤情的一致性。结果平原致伤组和高原致伤组驱动段压强分别为5.4 MPa和4.0 MPa时,可使各组小鼠死亡率基本一致(分别为65%和75%)。与各自对照组比较,平原5.4 MPa致伤组和高原4.0 MPa致伤组小鼠冲击伤24 h后肺脏均出现大面积出血(呈斑点状和弥散性),出血区域及附近有明显肺水肿;肺W/D比值增高,其中高原致伤组明显高于高原对照组(5.579±0.646比4.476±0.076,P<0.05),平原致伤组与平原对照组比较差异无统计学意义(5.303±1.020比4.015±0.144,P>0.05)。肺组织病理切片显示,与各自正常组比较,平原5.4 MPa致伤组和高原4.0 MPa致伤组均可见大片肺泡破裂融合,肺泡壁增厚,肺泡腔内有少量炎症细胞浸润;平原5.4 MPa致伤组和高原4.0 MPa致伤组小鼠肺组织损伤评分明显高于相应对照组(分:8.67±0.82比1.67±0.52,9.00±1.10比2.17±0.41,均P<0.05),但各致伤组间肺组织损伤评分比较差异无统计学意义。结论驱动压强5.4 MPa和4.0 MPa分别是制备相同伤情的平原和高原严重冲击伤参数,可相互转换,其结果为特殊环境严重冲击伤防治技术的应用和评估提供支撑。Objective To explore the establishment of the interconvertible injury parameters of same severe blast injury in mice at plain and plateau.Methods A total of 157 C57BL/6 male mice were randomly divided into plain control group(8 mice),plain injury group(77 mice),plateau control group(8 mice)and plateau injury group(64 mice)according to random number table method.The mice in plateau control group and plateau blast injury group had been placed in animal experimental low-pressure oxygen chamber to simulate 4000 meters plateau environment for 5 days in advance.Then the mice in plain blast injury group and plateau blast injury group were put into biological shock tube,respectively.Different pressures of the driving section were selected to establish the severe blast injury models in mice at plain and 4000 meters plateau to reach approximately 70%mortality within 72 hours.The equivalent traumatic condition at 24 hours after blast injury in different groups was verified by the series of experiments including gross autopsy,lung wet/dry weight ratio(W/D),hematoxylin-eosin(HE)staining and histological scoring.Results The mice mortality were basically consistent between the plain injury group(65%)and plateau injury group(75%)when 5.4 MPa and 4.0 MPa of the driving section pressures were chosen,respectively.Compared with the corresponding control groups,the lungs showed massive hemorrhage(patchy and diffuse)with significant pulmonary edema in both plain 5.4 MPa-injured group and the plateau 4.0 MPa-injured group at 24 hours after blast injury.Compared with the plateau control group,the pulmonary W/D ratio were significantly increased in the plateau injury group(5.579±0.646 vs.4.476±0.076,P<0.05),while the difference between plateau injury group and the plain control group was not statistically significant(5.303±1.020 vs.4.015±0.144,P>0.05).Also,compared with the corresponding control groups,the analysis of lung histopathological sections showed that there were several pathological changes including large alveolar rupture

关 键 词：平原 高原 严重冲击伤 相同伤情 致伤参数 

分 类 号：R642[医药卫生—外科学]