严重烧伤延迟复苏大鼠远隔脏器的能量代谢紊乱

Energy metabolic disturbance in the distant organs of severe burn rats following delayed resuscitation

目的:观察延迟复苏大鼠远隔脏器的能量代谢情况。方法:实验于2001-05/2004-08在长海医院烧伤中心实验室完成。取24只SD大鼠随机分为假烫组、烧伤组、早期复苏组、延迟复苏组4组,每组6只。①除假烫组外,其他3组大鼠用恒温水烫仪100℃水烫12s,制成体表面积30%Ⅲ度烧伤模型(病理证实),假烫组于37℃水中假烫12s。②伤后假烫组和烧伤组不液体复苏,早期复苏组在伤后30,90min分别用30mL/kg乳酸林格氏液腹腔注射液体复苏;延迟复苏组大鼠在伤后6,7h分别用40mL/kg乳酸林格氏液腹腔注射液体复苏。③所有大鼠伤后9h取材,测定肺、心、肝、肾组织Na+-K+-ATP酶活性,Ca2+-Mg2+-ATP酶活性,髓过氧化物酶活性,一氧化氮代谢产物量。结果:24只大鼠进入结果分析。①烧伤后9h延迟复苏组大鼠肺、心、肝、肾组织的Na+-K+-ATP酶活性分别为(0.16±0.03),(2.82±0.41),(1.96±0.29),(3.94±0.40)μkat/g,明显低于烧伤组和烧伤后早期复苏组(P<0.05或0.01)。②烧伤后9h延迟复苏组大鼠肺、心、肝、肾组织的Ca2+-Mg2+-ATP酶活性分别为(0.40±0.08),(3.71±0.70),(2.44±0.56),(2.39±0.57)μkat/g,也明显低于烧伤组和烧伤后早期复苏组(P<0.05或0.01)。③烧伤后9h延迟复苏组大鼠肺、心、肝、肾组织的髓过氧化物酶活性分别为(9.91±1.13),(0.80±0.09),(0.75±0.08),(0.76±0.09)μkat/g,明显高于烧伤组和烧伤后早期复苏组(P<0.05或0.01)。④烧伤后9h延迟复苏组大鼠肺、心、肝、肾组织中一氧化氮代谢产物量明显少于烧伤组和烧伤后早期复苏组(P<0.01)。结论:烧伤延迟复苏大鼠远隔脏器存在能量代谢紊乱,中性粒细胞积聚和一氧化氮产生减少可能是其重要机制。

AIM： To investigate the energy metabolism of distant organs in rats of delayed resuscitation. METHODS： The experiment was conducted in the Central Laboratory of Burn Surgery of Changhai Hospital between May 2001 and August 2004, Twenty-four SD rats were randomly divided into sham-burn group, burn group, early resuscitation group and delayed resuscitation group with 6 rats in each group. （1） Rats in all groups except the sham-burn group were burnt for 12 s with constant burning apparatus at 100 ℃ to prepare for burn of 30% Ⅲ in total body surface area （TBSA）, and rats in the sham-burn group were burnt in water at 37℃ for 12 s, （2） Rats in the sham-burn group and burn group received no fluid resuscitation after the burning, while rats in early resuscitation group were abdominally administrated with Lactated Ringer＇s solution at 30 mL/kg for fluid resuscitation respectively at 30 and 90 minutes after the burn, Rats in delayed resuscitation group were abdominally administrated with Lactated Ringer＇s solution （40 mL/kg） respectively at 6 and 7 hours after the burn for fluid resuscitation. （3） All rats were executed at 9 hours after the burn to determine the activities of Na^--K^--ATPase and Ca2^--Mg^2--ATPase in the tissues of lung, heart, liver and kidney as well as the activity of myeloperoxidase and the metabolites of nitric oxide （NO） RESULTS： A total of 24 rats were involved in the analysis of results, （1） Activities of Na^--K^--ATPase in the tissues of lung, heart, liver and kidney at 9 hours post burn in rats of delayed resuscitation group were（0.16±0.03）, （2.82±0.41）, （1.96±0.29）, （3.94±0.40） μkat/g respectively, which were obviously lower than those in the burn group and early resuscitation post-burn group （P 〈 0.05 or 0.01 ）, （2） Activities of Ca2^--Mg2^--ATPase in the tissues of lung, heart, liver and kidney at 9 hours post burn in rats of delayed resuscitation group were （0.40±0.08）, （3.71±0.70）, （2.44±0.56）, （2.39± 0.57） μkat/g respectively, which were obviously lower than those in the burn group and in the early resuscitation post-burn group （P 〈 0,05 or 0.01）.（3 ） The activities of myeloperoxidase in the tissues of lung, heart, liver and kidney at 9 hours after the burn in delayed resuscitation group were （9.91±1.13）, （0.80±0.09）, （0.75±0.08）, （0.76±0,09） μkat/g respectively, which were significantly higher than those in the burn group and eady resusdtation post-burn group （P 〈 0.05 or 0.01 ）. （4） The metabolites of NO at 9 hours after the burn in delayed resuscitation group were remarkably less than those in the burn group and eady resuscitation post-burn group （P 〈 0.01） CONCLUSION： The energy disturbance is found in the distant organs of rats with delayed resuscitation of severe bum, and the plymorphonuclear neutrophil （PMN） sequestration and decrease of NO production may play a pivotal role.