目标温度干预对热射病大鼠炎症反应及器官损伤的比较  

Comparison of target temperature intervention on inflammatory response and organ damage in rats with heat stroke

作　　者：王彬 吴长东[2] 王萍[2] 侯铭[2] 哈斯叶提·吐尔逊 黄小鲁[2] 申良红[2] 里提甫江·买买提艾力 阿依古丽·牙生[2] 穆叶赛·尼加提[2] WANG Bin;WU Changdong;WANG Ping;HOU Ming;Hasiyeti·Tuerxun;HUANG Xiaolu;SHEN Lianghong;Litipujiang·Maimaitiaili;Ayiguli·Yasheng;Muyesai·Nijiati(Graduate School of Xinjiang Medical University,Urumqi Xinjiang 830001,China)

机构地区：[1]新疆医科大学研究生院,新疆乌鲁木齐830001 [2]新疆维吾尔自治区人民医院,新疆乌鲁木齐830001

出　　处：《中国急救复苏与灾害医学杂志》2024年第2期233-236,241,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：新疆维吾尔自治区自然科学基金资助项目(编号:2020D01C106)。

摘　　要：目的 通过不同目标温度降温干预经典热射病大鼠,比较热打击大鼠炎症反应及器官损伤指标变化,探讨经典热射病适宜降温目标的选择。方法 雄性SD大鼠48只,按随机数字表法分为空白对照(NC)组和经典热射病(CHS)组、CHS0组(Tc℃)、CHS1组(Tc-1℃)、CHS2组(Tc+1℃),每组各12只。CSH组大鼠麻醉后俯卧置于热环境模拟仓,当核心体温达到42.0℃建立热射病大鼠模型。建模成功后立即使用室温水浴降温,降至设定分组的目标温度后,使用动物体温维持仪维持体温3 h。空白对照组始终置于室温环境。实验结束后收集大鼠腹主动脉血标本,ELISA检测血清中白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子α(TNF-α)水平,酶标仪检测血清中肌酸激酶(CK)、天冬氨酸氨基转移酶(AST)、谷氨酸转氨酶(ALT)、总胆红素(Tbil)的OD值,按照公式或标准曲线计算样本中酶的活性。结果 采用不同目标温度降温干预SD大鼠,实验结果表明:CHS0组IL-1β、IL-10、TNF-α、IL-6水平,CSH1组TNF-α、IL-6水平,CHS2组IL-10水平高于空白对照组(P<0.05)。CHS1、CHS2组TNF-α、IL-6水平低于CHS0组,CHS2组IL-10水平高于CHS0组,IL-6水平低于CHS1组(P<0.05)。器官损伤指标CK、AST、ALT水平高于空白对照组(P<0.05), CHS1、CHS2组CK、AST、ALT水平低于CHS0组,CHS2组低于CHS0组(P<0.05)。LDH、Tbil水平各组间比较无明显统计学差(P>0.05)。结论 采用不同目标温度降温干预可减轻热打击所致大鼠全身炎症反应及器官损伤,Tc+1℃组组炎症反应及器官损伤较轻。因此推测,Tc+1℃组降温干预可能对热打击大鼠具有更好的保护作用。Objective To study the cooling intervention of different target temperatures on rats with classical heat stroke.To compare the changes in inflammatory response and organ damage in rats with classic heat stroke and explore the selection of appropriate cooling targets.Methods 48 male SD rats were randomly divided into control group(NC,n=12),classical heat stroke(CHS)groups:CHS0 group(Core temperature,Tc℃,n=12),CHS1 group(Tc-1℃,n=12)and CHS2 group(Tc+1℃,n=12).Rats in the CSH groups were anesthetized and placed prone in a thermal environment simulation chamber.When the core body temperature reached 42.0°C,a heat stroke rat model was established.Immediately after successful modeling,a room temperature water bath was used to reach the target temperature of the set groups,an animal body temperature maintenance device was used to maintain the body temperature for 3 hours.The control group was placed at room temperature.The blood samples of abdominal aorta of rats were collected at the end of the experiments,and the levels of IL-1β,IL-6 IL-10 and TNF-αwere detected by ELISA.The OD values in serum of Creatine kinase(CK);Aspartate aminotransferase(AST);Glutamate transaminase(ALT);Lactate dehydrogenase(LDH);Total bilirubin(Tbil)were detected by enzyme labeling instrument,and the enzyme activities in the samples were calculated according to standard curves.Results The levels of IL-1β,IL-10,TNF-αand IL-6 in CHS0 group,TNF-αand IL-6 in CSH1 group and IL-10 in CHS2 group were higher than those in control group(P<0.05).The levels of TNF-αand IL-6 in CHS1 and CHS2 groups were lower than those in CHS0 group(P<0.05).The level of IL-10 in CHS2 group was higher than that in CHS0 group,and the level of IL-6 in IL-6 group was lower than that in CHS1 group(P<0.05).The levels of CK,AST and ALT in CHS groups were higher than those in control group.The levels of CK,AST and ALT in CHS1 and CHS2 groups were lower than those in CHS0 group,and those in CHS2 group were lower than those in CHS0 group(P<0.05).There was no significant

关 键 词：热射病 目标温度管理 炎症反应 器官损伤 

分 类 号：R594.1[医药卫生—内科学]