改良冬眠合剂对严重烫伤大鼠脏器功能的影响  

Effects of modified lytic cocktail on organ function of severely scalded rats

作　　者：于家傲 王际壮 王家强 章雄[1] 刘琰[1] Yu Jia'ao;Wang Jizhuang;Wang Jiaqiang;Zhang Xiong;Liu Yan(Department of Burn,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院灼伤整形科,上海200025

出　　处：《中华烧伤与创面修复杂志》2023年第11期1064-1071,共8页Chinese Journal of Burns And Wounds

基　　金：国家自然科学基金面上项目(82072173, 82172199);上海市生物医药领域定向项目(22DX1900600);上海市临床重点专科项目(shslczdzk02302);上海市综合医院中西医结合专项研究基金(ZHYY-ZXYJHZX-201911)。

摘　　要：目的对比改良冬眠合剂和传统冬眠合剂对严重烫伤大鼠脏器功能的影响。方法采用实验研究方法。取24只约10周龄雄性SD大鼠, 按照随机数字表法分为假伤组、单纯烫伤组、传统冬眠合剂组和改良冬眠合剂组, 每组6只。于单纯烫伤组、传统冬眠合剂组和改良冬眠合剂组大鼠背部造成30%体表总面积(TBSA)Ⅲ度烫伤, 假伤组大鼠模拟致伤过程致假伤。伤后即刻, 传统冬眠合剂组大鼠腹腔注射12 mL/kg由哌替啶、氯丙嗪和异丙嗪构成的传统冬眠合剂, 辅以生理盐水灌胃;改良冬眠合剂组大鼠腹腔注射2 mL/kg由咪达唑仑和芬太尼构成的混合药剂, 辅以西替利嗪灌胃。随后4组大鼠均腹腔注射乳酸林格液进行补液复苏, 使补液及给药总剂量为2 mL·kg-1·%TBSA-1。次日, 对2个冬眠合剂组大鼠再次同前给药。伤后3 d, 取各组大鼠腹主动脉血并留取肝脏、小肠和肺脏组织, 采用酶联免疫吸附测定法检测血浆中白细胞介素1β(IL-1β)、IL-10和IL-6水平, 采用全自动生化分析仪检测血浆中丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、γ-谷氨酰转移酶(γ-GT)、碱性磷酸酶(ALP)、乳酸脱氢酶(LDH)、LDH同工酶1(LDH-1)、肌酸激酶、肌酸激酶同工酶(CK-MB)、尿素、肌酐和尿酸水平, 对肝脏、小肠和肺脏组织行苏木精-伊红染色后观察组织学变化。对数据行单因素方差分析和Tukey检验。结果伤后3 d, 传统冬眠合剂组大鼠血浆中IL-10水平为(44±16)pg/mL, 显著高于改良冬眠合剂组的(20±9)pg/mL和单纯烫伤组的(21±6)pg/mL(P值均<0.05);4组大鼠血浆中IL-1β和IL-6水平比较, 差异均无统计学意义(P>0.05)。伤后3 d, 单纯烫伤组大鼠血浆中ALT和AST水平分别为(77±14)、(213±65)U/L, 均显著高于假伤组的(59±5)、(108±10)U/L(P<0.05);改良冬眠合剂组大鼠血浆中ALT和AST水平分别为(61±3)、(116±11)U/L, 均显著低于传统冬眠合剂组的(81±13)、(207±54)U/LObjective To compare the effects of the modified lytic cocktail and the classic lytic cocktail on organ function of severely scalded rats.Methods The experimental study method was applied.Twenty-four about 10-week-old male Sprague-Dawley rats were assigned into sham injury group,scald alone group,classic lytic cocktail group,and modified lytic cocktail group according to the random number table,with 6 rats in each group.In scald alone group,classic lytic cocktail group,and modified lytic cocktail group,rats were subjected to a 30%total body surface area(TBSA)full-thickness scald on the back.Rats in sham injury group underwent a simulated injury process to mimic a sham injury.Immediately after injury,rats in classic lytic cocktail group were intraperitoneally injected with a classic lytic cocktail(12 mL/kg)consisting of pethidine,chlorpromazine,and promethazine,supplemented with gavage using normal saline;and rats in modified lytic cocktail group were intraperitoneally injected with a mixed drug(2 mL/kg)consisting of midazolam and fentanyl,supplemented with gavage using cetirizine.Subsequently,rats in four groups were all intraperitoneally injected with lactated Ringer's solution for fluid resuscitation,with a total fluid and administration volume of 2 mL·kg-1·TBSA-1.On the following day,rats in the two lytic cocktail groups were administered medication once again as above.On post injury day(PID)3,the abdominal aortic blood,liver,small intestine,and lung tissue were collected from rats in each group.The plasma levels of interleukin-1β(IL-1β),IL-10,and IL-6 were measured using an enzyme-linked immunosorbent assay.The plasma levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),γ-glutamyl transferase(γ-GT),alkaline phosphatase(ALP),lactate dehydrogenase(LDH),LDH isoenzyme 1(LDH-1),creatine kinase(CK),CK isoenzyme(CK-MB),urea,creatinine,and uric acid were detected using an automated biochemical analyzer.The histological changes of liver,small intestine,and lung tissue were observed after perfo

关 键 词：烧伤 炎症 组织学 改良冬眠合剂 脏器损伤 

分 类 号：R644[医药卫生—外科学]