三种复温速率对兔肢体爆炸伤合并海水浸泡后肝肾功能的影响

Effect of different rewarming velocity on hepatic and renal function after explosive injury with seawater immersion in rabbit

目的观察三种复温速率对兔肢体爆炸伤合并海水浸泡后肝肾功能的影响。方法复制肢体爆炸伤合并海水浸泡致低体温[（31±0．5）℃]模型，成年家兔18只，随即等分为Ⅰ组[快速复温组，复温速率（8．94±0．93）℃／h]、Ⅱ组[缓慢复温1组，复温速率（3．88±0．22）℃／h]、Ⅲ组[缓慢复温2组，复温速率（2．18主0．12）℃／h]，以调节环境温度及加温输液的方法将体温恢复至38±0．5℃后维持该体温观察6h。于致伤前（T0）、浸泡降温后（T1）、复温即刻（T2）、复温后3h（T3）和复温后6h（T4）时相点检测血清谷丙转氨酶（GVF）、谷草转氨酶（GOT）、肌酐（Cr）和尿素氮（BUN），实验结束后取肝肾组织测定组织匀浆丙二醛（MDA）浓度、超氧化物歧化酶（SOD）活性。结果Ⅰ组GPT、GOT、Cr及BUN值在复温后3h及6h较Ⅱ、Ⅲ组明显升高（P〈0．05，P〈0．01），Ⅱ、Ⅲ组比较差异无统计学意义（P〉0．05）。Ⅰ组肝肾组织匀浆的SOD活性较Ⅱ组、Ⅲ组明显降低（P〈0．01，P〈0．05），MDA含量较Ⅱ组、Ⅲ组明显升高（P〈0．01）；Ⅱ组、Ⅲ组比较差异无统计学意义（P〉0．05）。Ⅲ组总尿量（130．7±92．2）mL明显高于Ⅰ组（75．5±35．1）mL、Ⅱ组（97．6±85．3）mL（P〈0．01）。结论肢体爆炸伤合并海水浸泡致低体温后，采取缓慢复温方式（复温速率为2～4℃／h）可以有效抑制机体脂质过氧化作用，提高机体抗氧化能力，对机体肝肾功能有一定的保护效应。

Objective To investigate the effect of different rewarming velocity on hepatic and real function after explosive injury with seawater immersion. Methods The low body temperature model induced with explosive injury with seawater immersion（ 31 ± 0.5）℃. Adult rabbits were randomly divided into group Ⅰ[rapid rewarming group, rewarming velocity （ 8.94 ±0.93 ）℃/h, n = 6 ], group Ⅱ [ slow rewarming group one, rewarming velocity （ 3.88 ± 0.22 ） ℃/h, n = 6 ], group m [ slow rewarming group two, rewarming velocity （ 2.18 ± 0.12 ） ℃/h, n = 6 ], and keep body temperature （ 38 ± 0.5 ） ℃ to 6 h after rewarming. Blood samples were collected on pro - injury （ T0 ） , pGOT - immersion （ T1 ） , after rewarming （T2） ,3 h after rewarming（Ta） ,6 h after rewarming（T4） , and liver and kidney tissue samples were collected. GOT（ glutamic - oxal（o） acetic transaminase）, GPT（ glutamic - pyruvic transaminase）, Cr（ creatinine） , BUN（ blood urea nitrogen） levels in plasma and T- SOD （malondialdehyde ） , MDA （superoxide dismutase） levels in homogenate were detected. Result Group [ Cr, BUN concentrations, GOT/GPT activity in plasma were significantly higher compared with that group Ⅱ and group Ⅲ （ P 〈 0. 05, P 〈 0.01 ） , and T - SOD activity in homogenate were significantly lower compared with that group Ⅱ and group Ⅲ （ P 〈 0. 01 ,P 〈 0.05 ） , and MDA concentrations in homogenate were significantly higher compared with that group Ⅱ and group Ⅲ （ P 〈 0.01 ）. group Ⅱ and group Ⅲ were no significantly difference（P 〉0. 05）. Group Ⅲ total urinary volume （ 130.7 ± 92.2 ） mL were significantly higher compared with that group （ 175.5±35.1 mL） and group Ⅲ（97.6±85.3 mL） （P〈0.01）. Conclusions Slowly rewarming treatment （ rewarming velocity 2 - 4 ℃/h） could inhibition lipid peroxidation reaction and improve the antioxidant ability, and these results suggested that there was a protection effect on hepatic and real function after explosive injury with seawater immersion.