中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2010年
24期
1707-1710
,共4页
蔡建华%柴家科%申传安%尹会男%邹晓防%刘伟%胡清刚%迟云飞%马丽%邓虎平%张西波%孙天骏%韩焱福
蔡建華%柴傢科%申傳安%尹會男%鄒曉防%劉偉%鬍清剛%遲雲飛%馬麗%鄧虎平%張西波%孫天駿%韓焱福
채건화%시가과%신전안%윤회남%추효방%류위%호청강%지운비%마려%산호평%장서파%손천준%한염복
烧伤%白细胞弹性蛋白酶%冲击伤%烧冲复合伤%大鼠
燒傷%白細胞彈性蛋白酶%遲擊傷%燒遲複閤傷%大鼠
소상%백세포탄성단백매%충격상%소충복합상%대서
Burns%Neutrophil elastase%Blast injuries%Burn-blast combined injuries%Rat
目的 探讨中性粒细胞弹性蛋白酶(NE)在大鼠烧伤、冲击伤与烧冲复合伤后早期血清中浓度的变化及意义.方法 选择雄性SD大鼠176只,随机分为对照(C)组、烫伤(BU)组、冲击伤(BL)组与烧冲复合伤(BB)组.C组不致伤;BU组背部脱毛置人94 ℃水中12 s,致25%体表面积(TBSA)Ⅲ°烫伤;BL组以5 g 8701压缩炸药柱为爆炸源,以左侧胸壁距爆炸源75 cm距离进行爆炸,致中度冲击伤;BB组同BL、BU组伤情先致冲击伤后立即烫伤.伤后24 h内,BU、BB组按照50 ml/kg,腹腔注射乳酸钠林格注射液抗休克治疗,1次/12 h.致伤组分为伤后3 h、6 h、12 h、1 d、2 d、3 d、7 d共7个时相点.测定各时相点支气管肺泡灌洗液(BALF)总蛋白浓度(BCA法)、肺组织含水率(称重法)及血清NE浓度(ELISA法).结果 各致伤组SD大鼠的BALF总蛋白浓度、肺组织含水率及血清NE浓度伤后各时相点均高于C组(P＜0.01或P＜0.05),其伤后峰值均出现在2 d以内,尤其是伤后2 d,BU组、BL组及BB组血清NE浓度分别为(319.85±19.50)ng/ml,(467.43±31.64)ng/ml,(626.00±26.38)ng/ml;C组(78.53±25.10)ng/ml.组间比较,总体伤情水平BB组＞BU组及BL组(P＜0.01或P＜0.05).相关分析表明,伤后3d内,BU组血清NE浓度与BALF总蛋白浓度、肺组织含水率均存在显著正相关(r=0.7910,0.8078,P＜0.05),BB组血清NE浓度与BALF总蛋白浓度存在显著正相关(r=0.8672,P＜0.05).结论 NE可能在烧伤、冲击伤,尤其是烧冲复合伤的早期肺损伤中起到了重要作用.
目的 探討中性粒細胞彈性蛋白酶(NE)在大鼠燒傷、遲擊傷與燒遲複閤傷後早期血清中濃度的變化及意義.方法 選擇雄性SD大鼠176隻,隨機分為對照(C)組、燙傷(BU)組、遲擊傷(BL)組與燒遲複閤傷(BB)組.C組不緻傷;BU組揹部脫毛置人94 ℃水中12 s,緻25%體錶麵積(TBSA)Ⅲ°燙傷;BL組以5 g 8701壓縮炸藥柱為爆炸源,以左側胸壁距爆炸源75 cm距離進行爆炸,緻中度遲擊傷;BB組同BL、BU組傷情先緻遲擊傷後立即燙傷.傷後24 h內,BU、BB組按照50 ml/kg,腹腔註射乳痠鈉林格註射液抗休剋治療,1次/12 h.緻傷組分為傷後3 h、6 h、12 h、1 d、2 d、3 d、7 d共7箇時相點.測定各時相點支氣管肺泡灌洗液(BALF)總蛋白濃度(BCA法)、肺組織含水率(稱重法)及血清NE濃度(ELISA法).結果 各緻傷組SD大鼠的BALF總蛋白濃度、肺組織含水率及血清NE濃度傷後各時相點均高于C組(P＜0.01或P＜0.05),其傷後峰值均齣現在2 d以內,尤其是傷後2 d,BU組、BL組及BB組血清NE濃度分彆為(319.85±19.50)ng/ml,(467.43±31.64)ng/ml,(626.00±26.38)ng/ml;C組(78.53±25.10)ng/ml.組間比較,總體傷情水平BB組＞BU組及BL組(P＜0.01或P＜0.05).相關分析錶明,傷後3d內,BU組血清NE濃度與BALF總蛋白濃度、肺組織含水率均存在顯著正相關(r=0.7910,0.8078,P＜0.05),BB組血清NE濃度與BALF總蛋白濃度存在顯著正相關(r=0.8672,P＜0.05).結論 NE可能在燒傷、遲擊傷,尤其是燒遲複閤傷的早期肺損傷中起到瞭重要作用.
목적 탐토중성립세포탄성단백매(NE)재대서소상、충격상여소충복합상후조기혈청중농도적변화급의의.방법 선택웅성SD대서176지,수궤분위대조(C)조、탕상(BU)조、충격상(BL)조여소충복합상(BB)조.C조불치상;BU조배부탈모치인94 ℃수중12 s,치25%체표면적(TBSA)Ⅲ°탕상;BL조이5 g 8701압축작약주위폭작원,이좌측흉벽거폭작원75 cm거리진행폭작,치중도충격상;BB조동BL、BU조상정선치충격상후립즉탕상.상후24 h내,BU、BB조안조50 ml/kg,복강주사유산납림격주사액항휴극치료,1차/12 h.치상조분위상후3 h、6 h、12 h、1 d、2 d、3 d、7 d공7개시상점.측정각시상점지기관폐포관세액(BALF)총단백농도(BCA법)、폐조직함수솔(칭중법)급혈청NE농도(ELISA법).결과 각치상조SD대서적BALF총단백농도、폐조직함수솔급혈청NE농도상후각시상점균고우C조(P＜0.01혹P＜0.05),기상후봉치균출현재2 d이내,우기시상후2 d,BU조、BL조급BB조혈청NE농도분별위(319.85±19.50)ng/ml,(467.43±31.64)ng/ml,(626.00±26.38)ng/ml;C조(78.53±25.10)ng/ml.조간비교,총체상정수평BB조＞BU조급BL조(P＜0.01혹P＜0.05).상관분석표명,상후3d내,BU조혈청NE농도여BALF총단백농도、폐조직함수솔균존재현저정상관(r=0.7910,0.8078,P＜0.05),BB조혈청NE농도여BALF총단백농도존재현저정상관(r=0.8672,P＜0.05).결론 NE가능재소상、충격상,우기시소충복합상적조기폐손상중기도료중요작용.
Objective To explore the early changes in serum neutrophil elastase(NE) in rats with burn.blast injury or combined bum-blast injury and its significance.Methors A total of 176 male Spragne Dawley rats were randomly divided into four groups:control(C),burn(BU),blast injury(BL) and burn-blast combined injury(BB).Rats in C group were not injured.Animals in BU group were subjected to 25% TBSA full-thickness burn on back with 94℃ water for 12 seconds;Animals in BL group were inflicted with moderate blast injury with 5g 8701 compressed dynamite stick as the explosion source 75 cm away while left chest facing the explosive source;Rats in BB group were burned immediately after the blot injury similarly as in BL group.During the first 24 h post-injury,animals in BU and BB groups received intraperitoneal bronchoalveolar lavage fluid(BALF),water content of lung tissue and NE content in serum were determined at 0 h(C group),3 h,6 h,12 h,1 d,2 d,3 d,7 d post-injury.Results Protein concentration in BALF,water content of lung tissue and NE content in serum in SD rats of the injured groups were significantly higher than those in C group(P＜0.01 or P＜0.05),peaked within 2 d post-injury,especially at 2 d post-injury(NE content in serum:BU group,319.85±19.50,ng/ml;BL group,467.43±31.64 ng/ml;BB group,626.00±26.38 ng/ml vs.C group,78.53±25.10 ng/ml).Overall,protein concentration in BALF.water content of lung tissue and NE content in serum in BB group were significantly higher than BU and BL groups(P＜0.01 or P＜0.05).Correlation analysis showed that within 3 d post-injury.a significant positive correlation was found between the protein concentration in BALF,water content of lung tissue and NE content in serum(r=0.7910,0.8078,P＜0.05) in BU group.NE content in serum and protein concentration in BALF were significantly positively correlated in BB group(r=0.8672,P＜0.05).Conclusion NE may play an important role in early lung injury of burn or blast injury,especially in combined bum-blast injury.
