大鼠烧伤早期肝细胞能量代谢改变及药物作用的观察

An observation on the effects of Actovegin on hepatocytic energy metabolism and the cellular structure during the early postburn stage in scalded rats

目的观察烧伤早期不同复苏条件下,肝细胞能量代谢的变化以及保护细胞药物-爱维治对肝细胞结构和能量代谢的影响。方法采用30%TBSAⅢ度大鼠烧伤模型,检测烧伤后立即补液、延迟补液及药物治疗情况下,肝组织及全血ATP含量、血清戊二醛水平的变化,并应用电镜观察肝细胞结构的改变。结果不论立即补液还是延迟补液,伤后肝组织ATP含量均明显下降,以延迟补液组为重,血清丙二醛水平升高,在延迟补液组还观察到肝细胞结构的明显异常;应用爱维治治疗可明显升高肝组织及全血ATP含量,降低血清丙二醛水平,并使肝细胞结构得到改善。结论烧伤早期肝细胞能量代谢受到抑制,延迟补液加重能量代谢紊乱;早期应用爱维治具有改善肝细胞能量代谢和保护细胞结构的作用。

Objective To investigate the early changes in hepatocytic energy metabolism and the effects of deproteinized hemodialyzate （Actovegin） on hepatocytic structure energy metabolism during the early postburn stage with different resuscitation methods in scalded rats. Methods One hundred and twenty-six adult Wistar rats were employed and were randomly divided into six groups after being inflicted by 30% TBSA full-thickness scald burn. The rats （n =24） in group A received fluid resuscitation with intraperitoneal Ringer＇ s lactate solution according to the Parkland formula （4 ml·kg^-1·%·burn^-1 ） immediately after scalding. The rats （n =24） in group B received fluid resuscitation as group A with Actovegin （200 mg/ kg） application intraperitoneally immediately and at 24 postburn hours （PBHs）. The rats （n = 24） in group C received delayed fluid resuscitation as group A at 6 hours after scald. The rats （n = 24） in group D received delayed fluid resuscitation with Actovegin as group B at 6 and 24 postburn hours （PBHs）. The rats （n=24） in group E received scalding without any treatment. The rats in group F （as control, n =6） received a sham scald injury. Hepatocytic energy was measured by the detection of liver tissue homogenate and blood adenosine triphosphate （ATP） at 6, 12, 24 and 48 PBHs. Serum malondialdehyde （MDA） content was examined to determine the tissue lipid peroxidation. The morphological changes of hepatocytes were observed with electronic microscope. Results The ATP in the hepatic tissue decreased obviously after scalding in both immediate and delayed fluid resuscitation groups, especially in delayed fluid resuscitation group. And the serum MDA content increased significantly after scalding. Evident abnormal changes in hepatocytic structure were identified in the delayed fluid resuscitation group. After the administration of Actovegin, the ATP content in hepatic tissue and whole blood increased and the serum MDA content decreased remarkably with the improvement of hepatocytic structure. Conclusions There existed the inhibition of hepatocytic energy metabolism which could be aggravated by delayed fluid resuscitation. The early application of Actovegin could improve the hepatocytic energy metabolism and protect the cellular structure.