高原高寒战时环境猪肢体枪弹伤后血浆PGF_(1α)和TXB_2含量的变化特点

Changes of PGF_(1α) and TXB_2 in plasma and rate of PGF_(1α)/TXB_2 after gunshot wound in pig's limbs under high altitude,high cold and war environment

目的探讨高原高寒环境下平战时肢体枪弹伤后血液中PGF1α、TXB。含量及PGF1α／TXB2的变化特点及意义。方法将24头小型猪随机分为高原战时致伤组（GZ）、高原平时致伤组（GP）和平原平时致伤组（PP），分别于伤前、伤后不同时相点采集静脉血定量测定PGF1α。TXB2含量。结果三组伤后血浆TXB2均显著升高，在伤后6h处形成一个高峰，然后稍有降低，在2d处形成一个低点，在3～5d处再次升高，7～10d时平原组和高原平时组基本恢复正常，高原战时组仍保持在较高水平；从总体情况看上升幅度依次为GZ〉GP〉PP。伤后PGF1α显著降低，其趋势与TXB2的变化趋势基本相反，下降幅度依次为GZ〉GP〉PP。PGF1α／TXB2的变化趋势与PGF1α基本一致。高原战时组在伤前就出现TXB2上升、PGF1α及PGF1α／TXB2下降。结论高原高寒战时环境猪肢体枪弹伤后全身血管发生强烈收缩和血小板聚集，血液处于高凝状态；易导致全身组织器官的缺血损伤、血栓形成和DIC等并发症。从严重程度上看依次为：GZ〉GP〉PP。

Objective To investigate the changing feature of of PGF1α and TXB2 in plasma and rate of PGF1α/TXB2 after gunshot wound in limbs under high altitude, high cold and peace or war environment. Methods Twenty-four pigs were divided into three groups randomly （ n = 8 ） ： high altitude, high cold and war environment group （ GZ）, high altitude and cold group （GP） and normal environment group （PP）. Venous blood was collected at different time before and after injury and the content of PGF1α and TXB2were measured. Results The content of TXB2 in plasma increased significantly after injury in all groups and formed a peak at 6h after injury. It decreased slightly and formed a low value at 2d after injury then it increased again at 3d to 5d after injury. At 7d to lOd after injury, it restored to normal value in PP and GP group but remained an upper level in GZ group. Totally, the increasing range of TXB2 was biggest in GZ group, follwed by GP and PP group. Contrarily to TXB2 , the content of PGFt~ decreased significantly in all groups after injury and the decreasing range was biggest in GZ group, follwed by GP and PP group. The changing tendency of PGF1α/TXB2rate was in accordance with that of PGF1α. The increase of TXB2 and PGF1α and decrease of PGF1α/TXB2 rate occurred before injury in GZ group. Conclusion Pantosomatous blood vessel contracted strongly, platelet congregated and blood was in high-coagulating state after gunshot wound in pig＇ s limbs under high altitude, high cold and war environment. This could induce systemic tissue and organ ischemic injury, thrombosis and DIC easily and it is most severe in GZ group followed by GP and PP group.