挤压伤大鼠肌肉组织间液生化指标变化研究

Research on biochemical index change of muscle interstitial fluid of crush injury rats

目的 观察模拟地震致Wistar大鼠后肢挤压伤后受压肢体肌肉组织间液生化指标变化,阐明其是否可以作为震后早期现场诊断大鼠挤压综合征指标之一.方法 选用60只Wistar大鼠,随机分为对照组（6只）和应用挤压伤动物模型致轻度、中度、重度挤压组（各18只）,每一挤压组按挤压时间再分4h、6h和8h三个小组（各6只）,于恢复再灌注前、再灌注后3h、6h、12h、24 h、48 h分别收集挤压伤后大鼠的受压肌肉组织间液,应用全自动生化分析仪检测组织间液中肌酸激酶（CK）、肌酐（Cr）、肌红蛋白（Mb）和乳酸脱氢酶（LDH）浓度的变化,使用SPSS17.0软件分析各组指标变化趋势.结果 4种受压肢体的组织间液生化指标CK、Cr、Mb、LDH随挤压力度增加而上升,随挤压时间延长而增加,其中轻、中、重挤压组作为整体损伤组与对照组比较差异有统计学意义,CK、Cr在挤压组间比较具有显著性差异.结论 本文反应地震致肢体挤压伤后早期组织间液生化指标连续性变化,提示组织间液的生化指标检测很有可能成为地震现场挤压综合征早期诊断指标之一.

Objective To observe the changes of interstitial fluid biochemical indexes in the compressed limb muscle tissue and the hind limbs of Wistar rats which were injured in the simulated earthquake, and elucidate if the changes of interstitial fluid biochemical indexes could serve as one of the indicators of crush syndrome in rats in the early site diagnosis after earthquake. Methods 60 Wistar rats were randomly divided into contrast group （6 rats） and the crushed group （18 rats）, including mild extrusion, moderate extrusion and severe extrusion, and the crushed group got crushed by the crush injury animal model. Each group was divided into three subgroups with 6 in each subgroup. The extrusion was conducted on 3-hour, 6-hour and 8-hour according to the extrusion time. 3-hour, 6-hour, 12-hour, 24-hour, 48-hour before and after reperfusion. Interstitial fluid of compressed rats＇ muscle tissue was collected. Detect the concentration changes in tissue fluid of CK, Cr, Mb and LDH by automatic analyzer. And the changing trend of the each examination was analyzed by SPSS17.0 software. Results Interstitial fluid and biochemical indexes of CK, Cr, Mb, LDH in the four kinds of compressed limbs increased along with the extrusion pressure. They also increased as extrusion time went on. The crushed groups, including mild extrusion, moderate extrusion and severe extrusion as groups of hull damage were compared with the contrast groups, and there was a striking difference between them. CK and Cr also had a striking difference between the crushed groups. Conclusion Crush injury of limbs after earthquake could cause significant changes in early stage of interstitial fluid biochemical indexes. It prompts the test of biochemistry index in the interstitial fluid that is a potentially early diagnostic criteria for crush syndrome in the earthquake areas.