三七皂甙对烧伤延迟复苏大鼠肺血管通透性的调控

Regulatory effect of Panax notoginseng saponins on pneum-vasopermeability of rats with delayed fluid resuscitation following severe burn

目的:观察三七皂甙对烧伤延迟复苏大鼠的肺血管通透性的影响及对肿瘤坏死因子α、白细胞介素10、髓过氧化物酶、内皮素1及其反馈调节的一氧化氮的调控。方法:实验于2003-07/2005-05在长海医院烧伤中心实验室完成。选用36只健康成年SD大鼠制备烧伤和烧伤休克延迟复苏模型,雌雄不限,体质量200～220g。随机数字表法分为假烫组、烫伤组、治疗组,每组12只。烫伤组以100℃水烫背部13s,造成大鼠30%体表总面积Ⅲ度烧伤(病理证实)。假烫组以38℃水模拟烫伤过程;治疗组伤后半小时腹腔注射三七皂甙(100mg/kg);烫伤及治疗组均于伤后6h腹腔注射乳酸林格液进行延迟复苏,总量按Parkland公式计算。伤后24h检测肺脏含水量、血管通透性及髓过氧化物酶活性的变化,血浆中肿瘤坏死因子α、白细胞介素10、内皮素1及一氧化氮的浓度水平。结果:36只大鼠均进入结果分析。①烫伤后24h,烫伤组的肺组织含水量显著高于假烫组和治疗组[(82.04±2.05)%,(76.85±2.18)%,(79.91±1.76)%,P<0.01,P<0.05]。②烫伤组的肺血管通透性、肿瘤坏死因子α和白细胞介素10的水平均显著高于假烫组与治疗组[(457.86±43.33),(49.46±10.16),(313.05±19.30)mg/L;(612.30±75.03),(32.68±9.33),(298.91±19.40)μg/L;(221.39±33.14),(6.99±1.84),(103.14±26.17)mg/L,P均<0.01],治疗组的各项指标显著高于假烫组(P<0.01)。③烫伤组的髓过氧化物酶活性显著高于假烫组和治疗组[(578.27±56.43),(106.80±9.94),(312.03±31.41)U/g,P<0.01]。④烫伤组的内皮素1高于假烫组及治疗组[(295.25±44.25),(60.08±11.65),(157.53±26.78)μg/L;P<0.01];治疗组的一氧化氮浓度高于假烫组与烫伤组[(4.25±0.59),(2.24±0.64),(3.18±0.72)mg/L,P<0.05,P<0.01],烫伤组内皮素1/一氧化氮浓度高于假烫组及治疗组[(96.85±24.20)×10-6,(27.67±4.86)×10-6,(38.15±10.62)×10-6,P<0.01]。结论:大鼠烧伤后,早期使用三七皂甙,可调控烫伤大鼠分泌肿瘤坏死因子α、白细胞介素10、内皮素1及一氧化氮和髓过氧化物酶活性,减轻肺组织的水肿,从而减轻烧伤早期脏器损害。

AIM： To investigate the effect of Panax notoginseng saponins （PNS） on pneum-vasopermeability of rats with delayed fluid resuscitation after severe burn and its regulation on tumor necrosis factor-α （TNF-α）, interleukin-10 （IL-10）, myeloperoxidase （MPO）, endothelin-1 （ET-1） and nitric oxide （NO）. METHODS： The experiment was conducted in the Central Laboratory of Burns, Changhai Hospital between July 2003and May 2005. Thirty-six healthy adult SD rats of either gender and 200-220 g weight were adopted and divided into sham-burn group, burn group and treatment group randomly, with twelve rats in each group. The dorsal skin of rats in the burn group were immersed into 100℃ water for 13 seconds to induce fullthickness dermal burns comprising 30% total body surface area （pathologically proved）. Rats in the sham-burn group were immersed into 38℃ water. PNS at 100 mg/kg were administered intraperitoneally in rats of the treatment group at 30 minutes post-burn. Rats in the burn and treatment groups were resuscitated by peritoneal injection with lactated Ringer lactate solution following Parkland formula at 6 hours post-burn. Water contents, vasopermeabilities and activities of MPO in lungs, and the levels of TNF-α, IL-10, ET-1 and NO in sera were assayed at 24 hours after burnt. RESULTS： Thirty-six enrolled rats adopted were involved in the analysis of results.①The water contents of lungs in rats of the burn group at 24 hours after burnt were significantly increased, compared with those in the sham-burn group and the treatment group [（82.04±2.05）%, （76.85±2.18）%, （79.91±1.76）%, P 〈 0.01, P 〈 0.05]. ②The vasopermeabilities of lungs, TNF-α and IL-10 in rats of the burn group were remarkably higher than those in the sham-burn group and the treatment group [（457.86±43.33）, （49.46 ±10.16）, （313.05 ±19.30） μg/g; （612.30 ±75.03）, （32.68 ±9.33）, （298.91±19.40） μg/L; （221.39±33.14）, （6.99±1.84）, （103.14±26.17） mg/L, P 〈 0.01]. However, the indexes were significantly higher in the treatment group than in the sham-burn group （P 〈 0.01）.③The activities of MPO of rats in the burn group were remarkably higher than those in the sham-burn group and the treatment group [（578.27±56.43）, （106.80±9.94）, （312.03 ±31.41） U/g, P 〈 0.01]. ④The level of ET-1 in rats were higher in the burn group than in the sham-burn group and the treatment group [（295.25 ±44.25）, （60.08±11.65）, （157.53±26.78） μg/L; P 〈 0.01], but the level of NO in rats were higher in the treatment group than those in the sham-burn group and the burn group [（4.25±0.59）, （2.24±0.64）. （3.18＋0.72） mg/L, P 〈 0.05, P 〈 0.01], and the ratio of ET-1/NO were remarkably higher in the burn group than in the sham-burn group and the treatment group [（96.85±24.20）×10^-6, （27.67±4.86）×10^-6, （38.15± 10.62）×10^-6, P 〈 0.01]. CONCLUSION： The levels of TNF-α, IL-10, ET-1 and NO in sera of rats and activity of MPO with severe burn can be regulated by early using of PNS, which contribute to palliate the oedema of lungs and relieve the earlier damage to burnt organs.