休克期切痂植皮对烫伤大鼠内脏能量代谢的影响

EFFECTS OF ESCHARECTOMY DURING BURN SHOCK STAGE ON ENERGY METABOLISM OF VISCERA IN RATS

采用大鼠３５％ 体表面积Ⅲ度烫伤模型，探讨严重烫伤后休克期切痂植皮对内脏ＡＴＰ含量的影响规律及其意义。实验动物随机分为烫伤对照组、２４ｈ 切痂组和９６ｈ 切痂组。分别检测伤前及伤后不同时间点心脏、肝脏ＡＴＰ含量、和血浆内毒素、肿瘤坏死因子－α水平。结果显示：烧伤后内脏ＡＴＰ含量迅速下降。非休克期切痂组较休克期切痂组ＡＴＰ水平下降显著（Ｐ＜ ０．０１）。内脏ＡＴＰ含量与血浆内毒素、肿瘤坏死因子－α水平呈显著负相关（γ＝ － ０．９１１～－ ０．９４３）。提示：烧伤后主要内脏有明显的代谢紊乱，能量的供应障碍和利用障碍同时存在。休克期切痂植皮可在一定程度上减轻烧伤后内脏的高代谢反应。

The present study was performed to evaluate the effects of escharectomy during burn shock stage on energy metabolism of viscera. 88 male Wistar rats were subjected to a 35% total body surface area fullthickness thermal injury. The rats were randomly divided into three groups: control group, escharectomy during burn shock stage group and escharectomy group after burn shock stage. The plasma levels of LPS and TNF α and the tissue contents of ATP in the heart and liver were seguentially determined at different time points. The results showed that the contents of ATP in the heart and liver decreased rapidly postburn. The contents of ATP in escharectomy group during burn shock stage were significantly higher than that in the other groups ( P <0.01). Significant negative correlations between the contents of ATP in viscera and levels of LPS, TNF α in plasma were noted. The data suggest that postburn energy disturbance involves not only energy production but also energy consumption, and escharectomy during burn shock stage could mitigate hypermetabolism after extensive burn to certain extent.