CAJ | 학술논문

目的了解"休克心"对严重烫伤大鼠早期肝、肾、肠损害是否具有启动作用.方法将56只Wistar大鼠随机分为对照组(8只),不予烫伤;烫伤组(48只),大鼠背部造成30%TBSA Ⅲ度烫伤,设伤后0.5、1.0、3.0、6.0、12.0和24.0 h观察时相点,每时相点8只大鼠.伤后30 min按Park-land公式腹腔注射乳酸林格液(4 mL·kg-1·1%TBSA-1).检测大鼠肝、肾、肠血流量;动脉收缩压(SBP)、动脉舒张压(DBP)、平均动脉压(MAP)、左心室收缩压(LVSP)、左心室舒张末期压(LVEDP)、左心室压力最大上升/下降速率(±dp/dt max);抽取各组大鼠静脉血检测其血清心肌肌钙蛋白I(cTnI)、总胆汁酸(TBA)、β2微球蛋白(β2-MG)、二胺氧化酶(DAO)含量.结果伤后1.0 h烫伤组大鼠肝、肾、肠血流量均明显降低.伤后12.0 h内均呈持续下降趋势,至伤后24.0 h仍显著低于对照组(P＜0.05或P＜0.01).烫伤组大鼠伤后1.0 h,LVSP和±dp/dt max即明显下降;伤后3.0 h,SBP、DBP、MAP明显下降;伤后6.0 h所有心脏功能指标均降低,至伤后24.0 h仍低于对照组(P＜0.01).与对照组[(1.71±0.07)μg/L]比较,伤后0.5 h烫伤组大鼠血清cTnI[(2.22±0.08)μg/L]即明显升高,伤后12.0 h[(7.07±0.44)μg/L]达峰值,伤后24.0 h[(4.57±0.30)μg/L]仍保持在较高水平(P＜0.01);伤后3.0 h血清TBA及伤后1.0 h血清β2-MG、DAO开始明显升高,并超过对照组(P＜0.05或P＜0.01),至伤后12.0 h仍呈上升趋势.结论严重烫伤后心肌损害在时间上明显早于其他脏器,且与其他脏器损害指标和血流量呈显著相关,提示"休克心"可能是严重烫伤后早期肝、肾、肠血流量减少和损害的启动因素之一,但还需深入研究以进一步证明.
목적 료해"휴극심"대엄중탕상대서조기간、신、장손해시부구유계동작용.방법 장56지Wistar대서수궤분위대조조(8지),불여탕상;탕상조(48지),대서배부조성30%TBSA Ⅲ도탕상,설상후0.5、1.0、3.0、6.0、12.0화24.0 h관찰시상점,매시상점8지대서.상후30 min안Park-land공식복강주사유산림격액(4 mL·kg-1·1%TBSA-1).검측대서간、신、장혈류량;동맥수축압(SBP)、동맥서장압(DBP)、평균동맥압(MAP)、좌심실수축압(LVSP)、좌심실서장말기압(LVEDP)、좌심실압력최대상승/하강속솔(±dp/dt max);추취각조대서정맥혈검측기혈청심기기개단백I(cTnI)、총담즙산(TBA)、β2미구단백(β2-MG)、이알양화매(DAO)함량.결과 상후1.0 h탕상조대서간、신、장혈류량균명현강저.상후12.0 h내균정지속하강추세,지상후24.0 h잉현저저우대조조(P＜0.05혹P＜0.01).탕상조대서상후1.0 h,LVSP화±dp/dt max즉명현하강;상후3.0 h,SBP、DBP、MAP명현하강;상후6.0 h소유심장공능지표균강저,지상후24.0 h잉저우대조조(P＜0.01).여대조조[(1.71±0.07)μg/L]비교,상후0.5 h탕상조대서혈청cTnI[(2.22±0.08)μg/L]즉명현승고,상후12.0 h[(7.07±0.44)μg/L]체봉치,상후24.0 h[(4.57±0.30)μg/L]잉보지재교고수평(P＜0.01);상후3.0 h혈청TBA급상후1.0 h혈청β2-MG、DAO개시명현승고,병초과대조조(P＜0.05혹P＜0.01),지상후12.0 h잉정상승추세.결론 엄중탕상후심기손해재시간상명현조우기타장기,차여기타장기손해지표화혈류량정현저상관,제시"휴극심"가능시엄중탕상후조기간、신、장혈류량감소화손해적계동인소지일,단환수심입연구이진일보증명.
Objective To investigate the instigating effect of"shock heart"on injury to liver,kid-ney and intestine at early stage of severe bum in rat. Methods Fifty-six healthy male Wistar rats were en-rolled in the study and randomly divided into normal control(n=8,without treatment,NC)and burn(n=48,inflicted with 30%TBSA full-thickness scald,B)groups.The rats in B group were intraperitonealy in-land formula,and they were observed at 0.5.1.0,3.0,6.0,12.0,24.0 post-burn hour(PBH),with 8 rats at each time point.The parameters concerning myocardial mechanics,including systolic blood pressure (SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP),left ventricular systolic pressure (LVSP),left ventficular end diastolic pressure(LVEDP),±dp/dt max were recorded.The volume of blood flow in liver,kidney and intestine were detected.The serum contents of cTnI,TBA,β2-MG,DAO were de-termined. ResuhsIn B group,LVSP and±dp/dt max decreased at 1.0 PBH,SBP,DBP and MAP de-creased at 3.0 PBH.all parameters of myocardial mechanics,decreased at 6.0 PBH and still lower than those in NC group at 24.0 PBH(P＜0.01).The volume of blood flow in liver,kidney and intestine in B group were markedly decreased at 1.0 PBH.and gradually decreased during 1.0 ～12.0 PBH,which were still lower than those in NC group at 24.0 PBH(P＜0.05 or P＜0.01).Compared with that in NC group (1.71±0.07 μg/L),the serum content of cTnI in B group were increased at 0.5 PBH(2.22±0.08 μg/L,P＜0.01),and peaked at 12.0 PBH(7.07±0.44 μg/L),and persisted at high level(4.57±0.30μg/L)at 24.0PBH.The serum contents of TBA at 3.0 PBH,β2-MG at 1.0 PBH,DAO at 1.0 PBH was obviously higher than those in NC group(P＜0.05 or P＜0.01),which all showed ascending tendency during 1.0～12.0 PBH. Conclusion Myocardial damage is earlier than other organs after severe burn.which is significantly correlated with the parameters of other organs damage and their blood flow volume.Shock heart may be one initiate factor to induce the damage of liver,kidney and intestine and decrease of their blood flow volume after severe burn.