家兔烫伤后早期痂下水肿液中白蛋白吸收现象及药代动力学观察

Absorption of albumin in subeschar tissue fluid in early stage after burn in rabbit and its pharmaco- kinetics

目的了解家兔烫伤后早期痂下水肿液中白蛋白的浓度变化，分析其规律。方法采用成年雄性新西兰家兔34只，按随机数字表法分成对照组和实验组，每组17只。实验组家兔背部制成8％TBSA的Ⅲ度烫伤，同时痂下注射人血白蛋白作为示踪白蛋白，于伤后2、4、8、16、24、48、72h取血液标本1.5mL；对照组家兔除不予烫伤外，其余处理同实验组。采用酶联免疫吸附测定试剂盒检测示踪白蛋白的浓度，以生化分析仪检测家兔血清白蛋白的浓度。采用3P97实用药代动力学计算程序拟合模型并计算示踪白蛋白的药代动力学参数。结果（1）实验组家兔伤后各时相点示踪白蛋白浓度均高于对照组（P〈0.01），于伤后8h达峰值[（421±10）μg／L]。（2）实验组家兔血清白蛋白浓度呈先下降后回升趋势，对照组浓度变化不大。（3）实验组家兔示踪白蛋白的分布相半衰期（4.0271h）约为对照组（12.0907h）的1／3，曲线下面积（22336.38μg·h·mL^-1）则约为对照组（5827.77μg·h·mL^-1）的4倍。结论正常情况下，皮下组织中的白蛋白可以回吸收进入血液循环；出现明显炎性反应（如深度烧伤）后其白蛋白回吸收更早、更快、量更大；烧伤后早期白蛋白经血管外渗的同时也存在回吸收入血的现象。

Objective To observe the change in albumin concentration in the subeschar tissue fluid of rabbits in early stage after burn, and to analyze its regular pattern. Methods Thirty-four adult male New Zealand rabbits were divided into control group and experiment group according to the random number table, with 17 rabbits in each group. Rabbits in experiment group were subjected to 8% TBSA full-thickness scald on the back and were injected with human serum albumin in subeschar tissue serving as tracing albumin. 1.5 mL blood sample was collected at post scald hour （PSH） 2, 4, 8, 16, 24, 48, 72 respectively. Rabbits in control group were dealt with the above-mentioned procedures except for scald. The concentration of tracing albumin was measured with the enzyme-linked immunosorbent assay kit. The concentration of the serum albumin of rabbits were determined with biochemical analyzer. Pharmacokinetics parameters of tracing albumin were calculated with fitting model of 3P97 practical pharmacokinetics calculating program. Results （1） Concentration of tracing albumin of rabbits in experiment group was respectively higher than that in control group （P 〈0.01） at each time point, and it peaked at PSH 8[（421±10）μg/L]. （2）The concen- tration of serum albumin of rabbits in experiment group decreased in the beginning and increased later, while no significant change was observed in control group. （3） The distribution phase half-life of tracing albumin of rabbits in experiment group （4.0271 h） was about 1/3 of that of the control group （12.0907 h） ; while the area under the curve in the experiment group （22 336.38μg·h·mL^-1） was about 4 times of that in the control group （5827.77μg·h·mL^-1）. Conclusions The albumin in the subcutaneous tissue could be absorbed into blood circulation in normal conditions. The resorption occurs earlier and faster and more when obvious inflammation occurs （such as deep burn）. Exudation and resorption of albumin co-exist in the early stage after burn.