利多卡因防治大鼠深二度烧伤创面早期加深的作用

Preventive and therapeutic effect of lidocaine on early progressive deep second degree burn wound

目的探讨利多卡因防治深二度烧伤创面早期加深的作用。方法wistar大鼠背部深二度烧伤,治疗组局部应用利多卡因凝胶,对照组涂抹安慰剂,检测烧伤后创面组织中Na-K-ATP酶、髓过氧化物酶(MPO)活性和琥珀酸脱氢酶(SDH)、丙二醛(MDA)的含量,HE染色及增殖细胞核抗原(PCNA)免疫组化染色显示创面组织坏死程度。结果对照组和治疗组SDH和Na-K-ATP酶活性在伤后24h均达到最低,之后逐渐升高,但远低于正常水平。伤后24h治疗组SDH、Na-K-ATP活性高于对照组(P<0.05);对照组MPO酶活性在伤后24h达最高,治疗组在伤后48h达最高,之后两组都降低,但仍高于正常水平,对照组MPO活性最高值高于治疗组(P<0.05);对照组和治疗组伤后MDA含量一直升高,伤后72h,对照组高于治疗组(P<0.05)。HE及PCNA染色显示治疗组早期创面进行性损伤明显延缓且较轻,创面组织增殖活力好于对照组。结论深二度烧伤创面早期局部应用利多卡因可减轻创面加深,其机制可能与抑制白细胞浸润、减轻氧化损伤、改善组织活力等因素有关。

Objective To study the preventive and therapeutic effect of lidocaine on early progressive deep second degree burn wound. Methods Wistar rats were divided into control group and treatment group. Rats in the treatment group were treated with local lidocaine gel, rats in the control group received placebo. Na＋-K＋-ATPase and myeloperoxidase（MPO） activity and succinate dehydrogenase（SDH） and malonaldehyde（MDA） level in wound tissue were measured. HE and immunohistochemical staining for proliferating cell nuclear antigen （PCNA） were performed to show the degree of wound tissue necrosis. Results In the control and treatment groups, the SDH and Na-K-ATPase activity reached the lowest at 24h after burn, and then gradually increased, but it was still much lower than their normal activity. Twenty-four hours after burn, the SDH and Na-K-ATPase activity was higher in the treatment group than in the control group （P0.05）. The MPO activity reached its peak in control group at 24h and in the treatment group at 48h after burn, respectively. Then, the MPO activity decreased in the two groups declined, but it was still higher than its normal activity. The peak MPO level was higher in the control group than in the treatment group（P0.05）. The MDA level in the two groups increased from 2h to 72h after burn. The MDA level was higher in the control group than in the treatment group（P0.05）. HE and immunohistochemical staining for PCNA showed that the early burn wound was milder and the proliferation activity of burn wound tissue was better in the treatment group than in the control group. Conclusion Topical application of lidocaine can prevent early progressive burn wound. Its mechanism may be related with the inhibition of white blood cell infiltration, alleviation of oxidized injury, and improvement in tissue vitality.