氢氟酸烧伤对肝细胞功能与超微结构的影响

The changes in hepatic structure and function following hydrofluoric acid burns

目的:探讨氢氟酸烧伤对大鼠肝脏功能与结构的影响及意义。方法:W istar大鼠80只,随机分为氢氟酸烧伤组(A)、等面积烫伤组(B)、大面积烫伤组(C)和对照组(D)。氢氟酸致A组大鼠背部6%总体表面积(TBSA)烧伤,热水致B组和C组大鼠背部Ⅲ度烧伤面积分别为6%TBSA和30%TBSA。分别于伤后5h、10h、24h取血、活杀。测定血标本内ALT、AST、LDH浓度,并通过投射电镜观察肝细胞超微结构的变化。结果:血清ALT、AST水平变化:A组大鼠伤后各时相点血清ALT和AST浓度均显著高于其它各组(P<0.01)。C组大鼠伤后5h和10h血清ALT和AST显著高于D组与B组动物(P<0.05);血清LDH水平变化:A组大鼠伤后血清LDH水平持续上升,其中5h血清LDH水平显著高于B组及D组动物(P<0.01),伤后10h、24h则显著高于其它各组(P<0.01)。C组大鼠伤后血清LDH水平显著高于B组和D组(P<0.01)。烧伤后肝线粒体形态结构变化:A组与C组大鼠肝细胞超微结构均显示,细胞质中线粒体较多,肿胀呈球形,脊消失。结论:氢氟酸烧伤后,肝脏损伤不仅较同面积烧伤严重,也较大面积烧伤严重,而肝线粒体形态改变远较同面积烧伤严重,与大面积烧伤接近,提示烧伤复合氟中毒能加重肝细胞结构与功能损伤。

Objective： To study the changes of hepatic structure and function in rats with hydrofluoric acid burned injury. Methods： Wistar rats were randomly divided into four groups, including group A, B, C and D. The rats of group A and B were received 6% third degree burned injury on the back with hydrofluoric acid or hot water respectively, and those of group C were received 30% TBSA third degree burned injury with hot water. Blood sampling were carried out at 5 hrs, 10hrs and 24hrs pest burns for examinations of ALT, AST and LDH. The hepatic ultrastructure was investigated with supermicroscope. Results： The levels of serum ALT and AST in rats of group A were significandy increased than that of others（P〈0.01）and the parameter of group C were notably higher than that of group B and D（P〈0.01）. The concentrations of serum LDH of group A were significandy increased than that of group B and D, and higher than that of group C at 10hrs and 24hrs pest burns（P〈0.01）. Serum levels of LDH of group C were markedly higher than that of group B and D（P〈0.01）. Mitochondria damages with swelling, vacuole-like changes, and disappearance of carina following hydrofluoric acid and large area burned injury were observed. Conclusion： The injuries of the liver indicted by AST, ALT, LDH and the ultrastructure of mitochondria were more seriously post hydrofluoric acid burned injury than those were injured only by hot water.