弹烧复合伤合并海水浸泡对血管内皮细胞止血功能的影响  

Effect of seawater immersion on hemostatic function of endothelial cells in dogs sustained burn-firearm combined injury

作　　者：闫红[1] 赖西南 葛衡江[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所麻醉科,重庆400042 [2]第三军医大学大坪医院野战外科研究所第六研究室,创伤烧伤复合伤国家重点实验室,重庆400042

出　　处：《第三军医大学学报》2004年第3期189-192,共4页Journal of Third Military Medical University

基　　金：全军"十五"指令性课题 ( 0 1L0 11)~~

摘　　要：目的　探讨弹烧复合伤合并海水浸泡对血管内皮细胞止血功能影响的原因和机制。方法　建立弹烧复合伤的犬实验模型 ,致伤后将犬随机分为非浸泡组和浸泡组 ,将浸泡组犬在海水中浸泡 4h后捞出 ,然后于伤后 4、7、10、2 0、2 8h分别取血检测循环内皮细胞 (circulatingendothelialcells ,CEC)、以及组织型纤溶酶原激活剂 (tissue typeplasminogenacti vator ,t PA)、纤溶酶原激活剂抑制物 (plasminogenactivatorinhibitor 1,PAI 1)、血栓素B2 (thromboxaneB2 ,TXB2 )和 6 酮 前列腺素1α( 6 keto prostaglandinF1α,6 K PGF1α)比值的变化 ,并且于伤后 2 8h活杀犬 ,取肺组织行病理检查。非浸泡组除不浸泡海水外 ,余检测时相及指标同浸泡组。结果　非浸泡组于伤后 4h和 7hCEC、PAI 1、TXB2 6 K PGF1α均升高 (P <0 0 5 ) ,t PA降低 (P <0 0 5 ) ,而浸泡组于伤后 4、7、10、2 0、2 8hCEC、PAI 1和TXB2 6 K PGF1α均持续增高 (P <0 0 5或P <0 0 1) ,t PA持续降低 (P <0 0 1) ;组间比较 :浸泡组从伤后 4h至伤后 2 8h ,各指标均与非浸泡组有显著差异 (P <0 0 5或P <0 0 1)。光镜下可见肺血管中血栓形成。结论　弹烧复合伤合并海水浸泡后可引起全身EC急性损伤以及造成EC止血功能紊乱 ,从而导致血栓形成 ,Objective To investigate the effect of seawater immersion on the hemostatic function of endothelial cells in dogs sustained burn firearm combined injury and the mechanisms. Methods Dogs with burn firearm combined injury were randomly divided into two groups: immersion group and control group. Dogs in immersion group were immersed in seawater for 4 h, and then taken out from seawater. Blood samples were collected from central vein before wound, immediately after immersion, at 4, 7, 10, 20, and 28 h after immersion to detect the changes in circulating endothelial cells (CEC), tissue type plasminogen activator (t PA), plasminogen activator inhibitor (PAI), and thromboxane B 2/6 keto prostaglandin F 1α (TXB 2/6 K PGF 1α ). Dogs were sacrificed at 28 h after wound for the purpose of pathological examination of the lung tissue. The indices detected except seawater immersion in the control group were the same as those in the immersion group. Results In the control group, the levels of CEC, PAI 1, and TXB 2/6 K PGF 1α increased, but the level of t PA decreased at 4 and 7 h after wound. However, in immersion group, the levels of CEC, PAI 1 and TXB2/6 K PGF1α kept increasing, but the level of t PA kept decreasing at 4, 7, 10, 20, and 28 h. Each index in immersion group from 4 h to 28 h after wound was significantly different from that in the control group ( P <0 05 or P <0 01). Thrombosis was found in lung tissues in the immersion group. Conclusion Seawater immersion after burn firearm combined injury can lead to extensive acute damage to endothelial cells and a disorder of hemostatic function of EC, resulting in thrombosis. The damage caused by immersion and burn firearm combined injury is more severe and lasting longer than that by simple burn firearm combined injury.

关 键 词：海水浸泡 弹烧复合伤 内皮细胞 止血 犬 

分 类 号：R123[医药卫生—环境卫生学] R644[医药卫生—公共卫生与预防医学]