CAJ | 학술논문

目的：观察胰岛素( INS)和丙酮酸乙脂( EP)拮抗严重烫伤后多器官功能不全综合征( MODS)大鼠炎症反应和氧化应激的效果。方法将80只SD清洁级30%体表面积Ⅲ度烫伤MODS大鼠随机分为INS治疗组( INS组, n=20)、EP治疗组(EP组,n=20)、INS和EP联合治疗组(INS+EP组,n=20)及治疗对照组(对照组,n=20)。 INS组、EP组、INS+EP组及对照组分别腹腔注射INS[2.0 U/(kg·d)]、EP[40 mg/(kg·d)]、INS+EP[2.0 U(kg·d)+40 mg/( kg·d)]及等体积林格液。测定并比较各组伤前及伤后1、3、5、7 d血糖、丙氨酸转氨酶( ALT)、肌酸激酶同工酶(CK-MB)、肌酐(Cr)及肿瘤坏死因子-α(TNF-α)、高迁移率族蛋白1(HMGB1)、丙二醛(MDA)、总抗氧化能力( TAC)。结果 INS组、EP组和INS+EP组伤后各时点血糖、ALT、CK-MB、Cr及血TNF-α、HMGB1和MDA水平均明显低于对照组(P<0．01),TAC水平明显高于对照组(P<0．01)；INS+EP组伤后各时点血ALT、CK-MB、Cr、TNF-α、HMGB1和MDA水平均明显低于INS组和EP组(P<0．01),TAC水平明显高于INS组和EP组(P<0．01)；INS+EP组和INS组伤后各时点血糖均明显低于EP组(P<0．01),INS+EP组伤后各时点血糖和INS组比较无显著差异(P>0．05),INS组伤后各时点血TNF-α、HMGB1、TAC水平均明显低于EP组(P<0．01),血MDA水平均明显高于EP组(P<0．01)。结论 INS和EP可有效降低严重烫伤后MODS大鼠机体过度炎症反应和改善氧化应激程度,但作用各有侧重,二者联合治疗效果优于单独治疗。
목적：관찰이도소( INS)화병동산을지( EP)길항엄중탕상후다기관공능불전종합정( MODS)대서염증반응화양화응격적효과。방법장80지SD청길급30%체표면적Ⅲ도탕상MODS대서수궤분위INS치료조( INS조, n=20)、EP치료조(EP조,n=20)、INS화EP연합치료조(INS+EP조,n=20)급치료대조조(대조조,n=20)。 INS조、EP조、INS+EP조급대조조분별복강주사INS[2.0 U/(kg·d)]、EP[40 mg/(kg·d)]、INS+EP[2.0 U(kg·d)+40 mg/( kg·d)]급등체적림격액。측정병비교각조상전급상후1、3、5、7 d혈당、병안산전안매( ALT)、기산격매동공매(CK-MB)、기항(Cr)급종류배사인자-α(TNF-α)、고천이솔족단백1(HMGB1)、병이철(MDA)、총항양화능력( TAC)。결과 INS조、EP조화INS+EP조상후각시점혈당、ALT、CK-MB、Cr급혈TNF-α、HMGB1화MDA수평균명현저우대조조(P<0．01),TAC수평명현고우대조조(P<0．01)；INS+EP조상후각시점혈ALT、CK-MB、Cr、TNF-α、HMGB1화MDA수평균명현저우INS조화EP조(P<0．01),TAC수평명현고우INS조화EP조(P<0．01)；INS+EP조화INS조상후각시점혈당균명현저우EP조(P<0．01),INS+EP조상후각시점혈당화INS조비교무현저차이(P>0．05),INS조상후각시점혈TNF-α、HMGB1、TAC수평균명현저우EP조(P<0．01),혈MDA수평균명현고우EP조(P<0．01)。결론 INS화EP가유효강저엄중탕상후MODS대서궤체과도염증반응화개선양화응격정도,단작용각유측중,이자연합치료효과우우단독치료。
Objective To observe the effect of Insulin ( INS) combined with Ethyl Pyruvate ( EP) in treatment of multiorgan dysfunction syndrome ( MODS) rats with inflammatory response and oxidative stress after severe burns. Methods A total of 80 MODS rats with degree III burns over 30% of body surface area were randomly divided into INS treatment group (n=20), EP treatment group (n=20), INS+EP group (n=20) and control group (n=20). The INS, EP, INS+EP and control groups were respectively given peritoneal injection with INS [2. 0 U/(kg·d)], EP [40 mg/(kg·d)], INS+EP [2. 0 U/(kg·d) +40 mg/(kg·d)] and same volume of Ringer Solution. The values of alanine transarninase ( ALT) , MB isoenzyme of creatine kinase ( CK-MB) , creatinine ( Cr) of blood glucose and concen-trations of tumor necrosis factor-α (TNF-α), high mobility group protein-1 (HMGB1), malondialdehyde (MDA) and total anti-oxidant capability (TAC) of blood in all groups were detected and compared before the injury and on 1st, 3rd, 5th and 7th d after the injury. Results The levels of ALT, CK-MB and Cr of blood glucose, and TNF-α, HMGB1, and MDA levels of blood in INS, EP and INS + EP groups at different time points were significantly lower (P<0. 01), while TAC levels were significantly higher than those in the control group (P<0. 01). The levels of ALT, CK-MB and Cr of blood glucose, and TNF-α, HMGB1 and MDA of blood at different time points in INS + EP group after burns were sig-nificantly lower ( P<0. 01 ) , while the TAC levels were significantly higher than those in INS and EP groups ( P <0. 01). The levels of blood glucose at different time points in INS + EP and INS groups after burns were significantly lower than those in EP group (P<0. 01). There were no significant differences in levels of blood glucose at different time points in INS + EP and INS groups after burns (P>0. 05). The levels of TNF-α, HMGB1 and TAC were significantly lower (P<0. 01), and the MDA levels were significantly higher at different time points in INS group after burns than those in EP group ( P<0. 01 ) . Conclusion Insulin and Ethyl Pyruvate can effectively weaken the inflammatory re-sponse and oxidative stress of MODS rats after severe burns. Both Insulin and Ethyl Pyruvate have their own advantages, and the effect of combination therapy is better than that of mono-therapy.