重视烧伤后淋巴循环系统的研究

Attach importance to research on lymph circulation system after burns

1淋巴循环系统（lymphatic circulation system）概述 淋巴循环系统是人体血液循环系统以外的另一重要体液循环系统和重要的免疫系统，它由淋巴管道（lymphatic vessel）、淋巴组织（lymphatic tissue）和淋巴器官（lymphatic organ）等组成。在正常生理状态下，有80％～90％的组织液被重吸收回流入血，

A series of pathophysiological changes in lymph circulation system occur after severe burns. We try to elucidate the importance through summarizing our experiments on some of the changes in lymph circulation based on rat and goat lymphatic fistula model since 1998. The lymphatic contraction frequency decreased while the lymph flow speed increased during burn shock stage. Contents of several key inflammatory factors, such as TNF-a, IL-6, IL-8, IL-10, IL-18, and HMGB-1 , were increased in lymph or lymph nodes, and they were higher than those in blood and liver. The protein concentration increased in lymph while decreased in plasma. The endotoxin was translocated to lymph earlier than to blood, therefore, the number of E. coil or the number of endotoxin translocated via lymph route were more than those via blood. The bacteria and endotoxin of pseudomonas aeruginosa could invade through local lymphatic route from infected burn wound. Th2 shift from Th1/Th2 occurred in lymph and the ratio of CD4 ＋/CD8＋ T lymph cells decreased in lymph nodes after burns, denoting local immunosuppression. The apoptosis of lymphocytes in lymph organ might contribute to this immunosuppression.