摘要
目的 了解早期应用冬眠合剂对严重烫伤大鼠小肠的保护作用.方法 将66只雄性SD大鼠按随机数字表法分为假伤组6只、烫伤组30只、烫伤＋冬眠合剂组30只.麻醉后,将后2组大鼠造成30%TBSAⅢ度烫伤,假伤组37℃水浴模拟烫伤.3组大鼠伤后均立即腹腔注射乳酸钠林格液（2 mL·kg-1·%TBSA-1）复苏;同时烫伤＋冬眠合剂组皮下注射冬眠合剂（50 mg/mL哌替啶、25 mg/mL氯丙嗪、25 mg/mL异丙嗪各1 mL加入125 mL生理盐水中）12 mL/kg,假伤组和烫伤组注射生理盐水12 mL/kg.分别于伤后3、6、12、24、48 h取烫伤组与烫伤＋冬眠合剂组大鼠各6只（假伤组伤后3 h取材）,采集血液和小肠组织标本.观察烫伤组与烫伤＋冬眠合剂组大鼠伤后24 h、假伤组伤后3 h小肠组织病理变化,并用免疫组织化学法检测小肠组织胞间黏附分子1（ICAM-1）和CD68的表达.采用ELISA法测定各组大鼠血浆D-乳酸、二胺氧化酶（DAO）、IL-1β、TNF-α、IL-10水平.数据行单因素方差分析.结果 （1）伤后24 h,烫伤组大鼠小肠黏膜轻度出血,炎症细胞浸润、上皮细胞脱落;烫伤＋冬眠合剂组较烫伤组肠绒毛排列规则,无明显充血、水肿表现.（2）烫伤组小肠ICAM-1和CD68阳性表达率分别为（1.69±0.27）%和（0.80±0.09）%,均显著高于假伤组的（0.77±0.10）%和（0.30±0.05）%（F值分别为77.303、66.933,P〈0.05或P〈0.01）与烫伤＋冬眠合剂组的（0.53±0.09）%和（0.32±0.06）%（F值同前,P值均小于0.01）.（3）烫伤＋冬眠合剂组大鼠伤后12、24 h D-乳酸水平明显低于烫伤组（F值分别为20.936、19.854,P值均小于0.01）.烫伤＋冬眠合剂组DAO水平于伤后3、12 h显著低于烫伤组（F值分别为21.930、11.342,P值均小于0.05）.（4）烫伤组各时相点IL-1β、TNF-α水平均明显高于假伤组（P值均小于0.01）,烫伤＋冬眠合剂组伤后6、12、24 h IL-1β、TNF-α水平均低于烫伤组（F值分别为96.517、
Objective To study the protective effect of early application of lytic cocktail on small intestine of severely scalded rats. Methods Sixty-six male SD rats were divided into sham injury group （SI, n =6） , scald group （S, n = 30） and scald ＋ lytic cocktail group （SL, n =30） according to the random number table. After anesthesia, rats in the latter 2 groups were inflicted with 30% full-thickness scald, while rats in S group were sham scalded with 37 ℃ water. Resuscitation was carried out by intraperitoneal injection with 2 mL · kg-1 · %TBSA-1 lactated Ringer＇s solution in all rats; meanwhile 12 mL/kg lytic cocktail [ 1 mL pethidine （50 mg/mL） ＋ 1 mL chlorpromazine （25 mg/mL） ＋ 1 mL promethazine （25 mg/mL） ＋ 125 mL saline] was hypodermically injected to rats in SL group, while 12 mL/kg saline was injected into rats in the other 2 groups. Samples of blood and small intestine were harvested from S and SL groups at post scald hour （PSH） 3, 6, 12, 24, 48 and from SI group at PSH 3, with 6 rats in each group at each time point. Pathological changes in intestine were observed, and the expression of intercellular adhesion molecule 1 （ICAM-1） and CD68 were determined with immunohistochemistry at PSH 24 for S and SL groups and at PSH 3 for SI group. Plasma levels of D-lactate, diamine oxidase （DAO） , IL-1β, TNF-α, IL-10 were determined with ELISA. Data were processed with one-way analysis of variance. Results （1） At PSH 24, mild hemorrhage, inflammatory cell infiltration and epithelial cell shedding were observed in small intestinal mucosa of rats in S group.Compared with S group, the intestinal villi of SL group were arranged regularly without obvious hyperemia and edema. （2） Expression levels of ICAM-1 and CD68 [（1. 69 ± 0.27）%, （0.80 ±0.09）%] in S group were significantly higher than those in SI group [（0.77 ± 0. 10） % , （0. 30 ± 0. 05） % , with F value respectively 77. 303 and 66. 933 , P 〈 0.05 or P 〈 0.01] and SL group [（0. 53 ± 0.09
出处
《中华烧伤杂志》
CAS
CSCD
北大核心
2010年第3期180-184,共5页
Chinese Journal of Burns
基金
上海交通大学医学院自然科学研究基金（2007XJ012）
关键词
烧伤
内皮细胞
小肠
冬眠合剂
炎症反应
Burns
Endothelial cells
Intestine, small
Lytic cocktail
Inflammatory response
