高原寒区战时枪弹伤对健康肌肉组织酶活性和物质消耗的影响

Effect of Gunshot Wound on Enzyme Activity and Substance Consumption of Healthy Muscular Tissue in High-altitude Cold Area during Wartime

目的探讨高原寒区平、战时枪弹伤对机体健康肌肉组织酶活性和物质消耗的影响。方法将24头实验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),每组8头,分别于伤前、伤后不同时相点取背部健康肌肉组织匀浆后定量测定Na+-K+-ATP酶、乳酸脱氢酶(lactate dehydrogenase,LDH)、磷酸肌酸激酶(creatine kinase,CK)、肌糖元(muscle glycogen,MG)、乳酸(lactic acid,LA)、游离无机磷(Pi3+)的含量。结果①伤后2hPP组、GP组和GZ组LDH的活性分别是伤前值的3.73倍、2.76倍和2.75倍,PP组伤后2d开始降低、而GZ、GP两组从伤后2h开始逐渐上升,到5d时与平原组接近。②三组动物伤后CK均逐渐升高并于伤后12h到顶峰,PP组、GP组和GZ组分别为伤前的2.07倍、1.77倍和1.70倍。③三组动物伤后ATP酶活性均显著升高,并于伤后6h达最高点,PP组、GP组和GZ组分别为伤前的2.29倍、1.75倍和1.62倍,此后逐渐下降。④三组伤后肌糖元变化规律相似,在伤后2h形成一个显著的低点,PP组、GP组和GZ组分别为伤前的81.5%、75.3%和73.8%,此后逐渐回升。⑤GZ组伤后2h时乳酸达峰值,为GP组的1.58倍,此后有逐渐下降的趋势。⑥三组动物伤后健康肌肉组织中的游离无机磷逐渐减少,伤后2d～3d出现一个显著的低点,下降的幅度大小依次为高原战时组>高原平时组>平原平时组,高原战时组最低值为高原平时组最低值的84.2%,为伤前的39.0%。结论高原战时环境枪弹伤后机体组织酶活性储备能力降低,可代偿能力下降,长时间处于高耗能状态。

Objective To investigate the effect of gunshot wound on enzyme activity and substance consumption of healthy muscular tissue in high-altitude cold area in peacetime and wartime.Methods Twenty-four pigs were randomly divided into normal environment group（PP,n=8）,high-altitude peacetime group（GP,n=8）,and high-altitude wartime group（GZ,n=8）.Healthy muscular tissue in the body dorsum was collected at different timepoints before and after injury to make homogenate for measurement of Na^＋-K^＋-ATPase,lactate dehydrogenase（LDH）,creatine kinase（CK）,muscular glucogen（MG）,lactic acid（LA） and inorganic phosphorus（IP）.Results ①The LDH activity in PP,GP and GZ groups was 3.73,2.76 and 2.75 times of pre-injury value respectively 2 hours after injury,and started decreasing 2 days after injury in PP group,while increased gradually since 2 hours after injury in GP and GZ groups and approached to the levels of PP group 5 days after injury.②The CK content increased gradually after injury and reached peak 12 hours after injury in all groups,and was 2.07,1.77 and 1.70 times of pre-injury value respectively in PP,GP and GZ groups.③The ATPase activity increased gradually after injury and reached peak 6 hours after injury in all groups,and was 2.29,1.75 and 1.62 times of pre-injury value respectively in PP,GP and GZ groups,then decreased gradually.④The changes of MG after injury were similar in the three groups.It decreased to a low value 2 hours after injury,and was 81.5%,75.3% and 73.8% of pre-injury value respectively in PP,GP and GZ groups,and then increased gradually.⑤The LA content reached peak 2 hours after injury in GZ group,and was 1.58 times of that in GP group,and then presented a decreasing trend.⑥The Pi^3＋ content in healthy muscular tissue decreased gradually after injury in all groups,and reached a significantly low value 2 days to 3 days after injury.The decreasing range was GZGPPP.Its lowest value in GZ group was 84.2% of that in GP group,and was 39.0% of pre-injury value.Conclusion The spare capacity of enzyme activity and its compensability decrease after gunshot wound and the body is at a high energy-consumption state for a long period of time in high-altitude area during wartime.