严重烧伤兔早期使用亚胺培南对体内α-肿瘤坏死因子的影响

Effects of early administration of imipenem on subeshcar and plasma TNF-α in rabbits with severe burns

目的观察在严重烧伤早期应用亚胺培南对痂下组织液和血浆中TNFα的影响。方法将16只家兔随机分为2组,即烧伤后亚胺培南治疗组和烧伤后生理盐水对照组。2组分别于伤后20min内静滴100mg泰能和等量生理盐水,8h/次,共3d,并补液抗休克。采用ELASA法检测2组痂下组织液和血浆中TNFα的含量。结果家兔烧伤后血浆中TNFα含量较伤前明显增高,伤后16h达到高峰,并维持较高水平至伤后72h。在各相同时点,痂下组织液中TNFα分别较血浆中TNFα含量有显著增高。在烧伤早期应用亚胺培南治疗组痂下组织液和血浆中TNFα的水平明显低于对照组。结论严重烧伤早期使用亚胺培南,痂下组织液和血浆中TNFα水平较对照明显降低,提示亚胺培南对TNFα、内毒素释放呈低诱导状态,有利于防止和减轻内毒素血症的发生。

Objective To study the changes in subeschar fluid and plasma TNF-α in rabbits with severe burns in response to early administration of imipenem (IPM). Methods Sixteen rabbits with severe burns were randomized into 2 two equal groups to receive treatment with 100 mg (100 ml) of IPM q8 h×3 days and equivalent volume of saline , respectively. The levels of TNF-α in the subeschar tissue fluids and plasma were determined by double-antibody sandwich enzyme-linked immunosor- bent assay (ELISA) after the first initial dose of 100 mg of imipenem/cilastatin, lasting 3 days. Results The plasma TNF-α levels in rabbits increased after the burn injury, reaching the peak level 16 h postburn and sustained the high levels till 72 h. At the same time point, TNF-α levels in the subeschar tissue fluids increased evidently in comparison with the plasma level, but both were lowered with early administration of imipenem (P<0.05). Conclusion Subeschar and plasma levels of TNFα can be significantly lowered with early-stage administration of imipenem, suggesting that IPM inhibits the release of TNFα and endotoxin to relieve or prevent endotoxemia after sever burn injury in rabbits.