休克期切痂植皮对烧伤大鼠能量代谢的影响

Effects of escharectomy during shock stage on energy metabolism in burned rats

目的 :考察伤后不同时期切痂对烧伤大鼠能量代谢的影响。方法 :4 0只成年雄性大鼠 ,采用 30 %TB SA三度烫伤模型 ,分为 5组 :伤前正常对照组、单纯烫伤对照组、伤后 8h、2 4h、96h切痂植皮治疗组 ,于烫伤后16 8h处死大鼠。结果 :①烫伤后大鼠血清TNFα、花生四烯酸水平显著高于伤前 ,切痂后降低 ,其中 8h、2 4h切痂组TNFα水平及 8h切痂组花生四烯酸水平显著低于单纯烫伤组。各组胰高血糖素、皮质醇水平的改变均不具显著性。②烫伤后骨骼肌ATP含量显著降低而ADP含量显著升高 ,EC水平略下降 ;切痂后ATP、EC水平均有恢复 ,其中 8h、2 4h切痂组ATP含量及 8h切痂组EC水平显著高于单纯烫伤组。肝脏ATP含量于烫伤后亦显著低于伤前 ,切痂后略回升 ;切痂后肝脏EC水平升高 ,其中 2 4h切痂组EC水平显著高于单纯烫伤组。结论 :严重烧伤后组织ATP、能荷水平的降低是高代谢重要表现之一 ,该现象与细胞因子、脂类介质水平升高有关 。

Objective:To investigate the influence of. escharectomy during shock stage on the energy metabolism as well as some related factors in bured rats. Methods:Thirty two Wistar rats inflicted with 30% TBSA Ⅲ degree scalds were employed as model and were divided into scalding control (SC), and treading groups (T). The latter was further divided into three subgroups according to the time of escharectomy, i.e. 8 postburn hour (PBHs) (T8), 24 PBHs (T24) and 96 PBHs (T96) groups. The rats were killed in 168h postburns. Eight rats were designed as normal control (NC). The levels of ATP content, energy charge (EC) in skeletal muscle and liver, as well as TNFα, arachidonic acid, glucagon and cortisol in plasma were determined. Results:(1)The levels of TNFα and arachidonic acid increased significantly postburns and both of them decreased after receiving escharectomy. The levels of TNFα in T8 and T24 as well as arachidonic acid in T8 were significantly lower than those in SC. There were not significant changes of glucagon and cortisol in all the groups. (2) In skeletal muscle, ATP content in SC was significantly lower than that in NC. EC decreased to some extent too. ATP content and EC restored partially after receiving escharectomy. ATP contents in T8 and T24, EC in T8 were significantly higher than those in SC. In liver, ATP contents decreased significantly postburns. After receiving escharectomy in 24h postburns, EC restored partially and was significantly higher than that in SC. Conclusion:Decreased ATP contents and EC in certain tissues were important manifestations of hypermetabolism after major burns. To conduct escharectomy during shock stage could help to restore both of ATP contents and EC in the tissues as well as depress hypermetabolism.