低浓度甘露醇对重度烧伤休克影响的实验研究

Effects of low-concentration mannitol on severe burn shock in rabbits

目的观察低浓度甘露醇对重度烧伤休克动物模型氧自由基清除率及重要脏器功能的影响。方法将16只新西兰大白兔按配对比较法分为4%甘露醇组和5%甘露醇组,每组8只,制作总体表面积30%的Ⅲ度烧伤模型。两组动物分别于伤后8h缓慢静脉滴注相应浓度甘露醇,第1个24h剂量0.6g/kg,第2、3个24h均为1.2g/kg。首次用药前和用药后1h测定血浆渗透压,24、48、72h检测血液中超氧化物歧化酶(SOD)活性、丙二醛(MDA)含量、血乳酸、IL-6、TNF-α水平及其他血生化指标。72h后处死动物,检测心、肾、空肠组织中SOD活性和MDA含量。结果两组动物血浆渗透压差均<10m Osm/L,血生化指标、血乳酸、IL-6、TNF-α水平两组比较均无统计学差异(均P>0.05),SOD活性和MDA含量也均无统计学差异(均P>0.05)。结论 5%甘露醇与4%甘露醇抗休克治疗效果差异不明显,但5%甘露醇对患者液体入量影响较小,故可作为重度烧伤抗休克辅助治疗更好的选择。

Objective To investigate the effect of low-concentration mannitol on severe burn shock. Methods Sixteen New Zealand healthy rabbits were randomly divided into 2 groups： 4% mannitol intravenous drip group （n=8） and 5% mannitol intravenous group （n=8）. The 30% total body surface area （TBSA） grade III burn model was induced and the conventional anti shock therapy was given. The dosage of mannitol was 0.6g/kg q.d at the first 24h and 0.6g/kg q.d at the second and third 24h. Plasma osmotic pressure was measured at 1 h before and after intravenous infusion of mannitol. At 24h, 48h, and 72h after infusion blood SOD, MDA, lactic acid, LDH, CK, BUN, Cr, AST, ALl-, albumin, IL-6 and TNF-cx levels were measured. The animals were sacrificed at 72h, the SOD activity and MDA contents in the heart, lung, liver, kidney and jejunum of the animals were determined. Single factor analysis of variance, and the LSD-t test were used for statistical analysis. Results There were no significant differences in liver function, renal function, myocardial endyme spectrum index, inflammatory mediators, SOD, MDA, albumin, lactic acid levels between two groups at the corresponding time points. Conclusion There are no significant difference between 5% mannitol and 4% in anti-shock effect for severe burn injury; but 5% mannitol may be a better choice because it can promote the velocity and quality of anti-shock fluid therapy. [ Key words ] Burn Mannitol Concentration Shock