大鼠烧伤后立即切痂对心肌损伤的保护作用

Effects of prompt escharectomy on myocardial injury after severe burns in rats

目的：探讨烧伤后即行切痂对心肌损伤的防治作用。方法：建立３０％ＴＢＳＡⅢ°烧伤大鼠伤后立即一次性切痂模型，动物随机分为对照组（ｎ＝１０），未切痂组（ｎ＝５０）和切痂组（ｎ＝５０），于伤后１、３、６、１２和２４ｈ检测血浆肌球蛋白轻链１（ＭＬＣ１）、血浆及心肌组织ＴＮＦ等指标。结果：烧伤后６ｈ血浆ＭＬＣ１、ＴＮＦ即显著升高，心肌组织中ＴＮＦ也在伤后１２ｈ显著升高。未切痂组与切痂组比较，伤后１～６ｈ未切痂组ＭＬＣ１略低于切痂组，至伤后１２ｈ，未切痂组ＭＬＣ１、ＴＮＦ显著高于切痂组。ＭＬＣ１与ＴＮＦ存在显著正相关。结论：伤后即行一次性切痂可以降低血浆ＭＬＣ１和ＴＮＦ水平。

Objective: To investigate the therapeutic effects of prompt escharectomy on myocardial injury following severe burns. Methods: Wistar rats were randomized into 3 groups: the control group (CG, n =10), non escharectomy group (NEG, n =50) and escharectomy group (EG, n =50). The animals in NEG and EG were inflicted with 30% TBSA full thickness skin burns. The plasma levels of myosin light chain 1 (MLC 1) and tumor necrosis factor (TNF) and the content of TNF in myocardial tissue were determined at the 1st, 3rd, 6th, 12th and 24th h postburn (HPB). Results: The plasma levels of MLC 1 and TNF at 6 HPB and TNF content in the myocardial tissue at 12 HPB were markedly higher in NEG and EG than in CG. At 6 HPB, the plasma level of MLC 1 was slightly higher in NEG than in NG. At 12 HPB, the levels of MLC1 and TNF were remarkably higher in NEG than in NG. MLC 1 was significantly correlated to TNF. Conclusion: Prompt escharectomy can reduce plasma levels of MLC1 and TNF, which suggests that prompt escharectomy can exert protective and therapeutic effects on myocardial injury following severe burns.