锌营养状态对烧伤创面修复的影响

Effect of zinc nutritive status on repair of burn wound

目的:研究烧伤动物缺锌状况,通过不同剂量、不同途径补锌观察对创面愈合的影响。方法:Wistar大鼠80只,以沸水烫伤8秒致15%深Ⅱ度烫伤,设正常对照组(C组),通过经口和创面补锌的三组,分别以正常含锌饲料(40mg/kg,N组)、高锌饲料(80mg/kg,H组)喂养,正常含锌饲料加创面涂银锌霜(含锌761mg/kg,W组),于伤后1、3、7天活杀动物取血,检查血清锌含量和生长激素(GH)水平,取烫伤皮肤检测组织中的锌含量和羟脯氨酸(OHP)水平。另设2组大鼠,对比外用银锌霜或碘伏后刨面愈合过程。结果:伤后第1天血锌、皮肤锌及OHP即明显降低,血GH略有升高,饲以高锌饲料可以尽快提高血锌、皮肤锌和血GH水平,经创面补锌可以提高皮肤锌、皮肤OHP含量,有助于加速创面修复。在创面愈合过程的对比中发现,应用银锌霜的深Ⅱ度创面12.3±2.1d即愈合,而对照组至21天只有66.7%的创面愈合。结论:烧伤后血锌、皮肤锌及皮肤OHP水平都降低,经口饲和创面补锌均可提高上述水平,口饲补锌侧重于提高血锌和GH水平,创面补锌有助于增加皮肤中锌和OHP含量,且能促进创面愈合。

Objective:To study the condition of zinc deficiency in burned animal and its influence on wound healing with zinc supplementation in different dosages and routes. Method: 80 Wistar rats were subjected to 15% TBSA deep second degree thermal injury. They were divided into normal controls, zinc supplementation by diet group and that through wound surface group. The rats were fed with diets containing normal amount of zinc (40mg/kg, N group), high zinc content (80mg/kg, H group) and normal zinc content, together with application of Ag-Zn sulfadiazine cream (761mg/kg W group) respectively. The rats were killed on 1,3,7 days postburn. The serum zinc and growth hormone (GH), wound zinc and hydroxyproline (OHP) levels were measured. Two additional groups served as controls by application of either Ag-Zn cream or iodophor on wound to observe wound healing. Results: The levels of serum zinc, wound zinc and OHP decreased markedly and serum GH increased on first postburn day (PBD). The levels of serum zinc, wound zinc and serum GH increased quickly with high zinc diet supplementation. When zinc was supplied through wound, burn wound zinc and OHP increased, contributing to wound repair acceleration. The wound of deep second degree healed on 12.3±2. 1day in Ag-Zn SD cream group, but 66.7% of wounds healed on 21 PBD in control group. Conclusion: The levels of serum zinc, wound tissue zinc and OHP were lowered after thermal injury and they could be elevated after supplementing zinc by diet or through wound. The serum zinc and GH level went up after diet supplementation. Also, supplementing zinc through wound could contribute to elevation of wound zinc and OHP, thereby promoting wound healing.