钝性胸部创伤后体内部分激素含量与血流动力学变化的关系

Relationship between the changes of the plasma hormones and hemodynamics after blunt chest trauma in rabbits

目的 探讨钝性胸部创伤 (BCT)后体内部分激素含量和血流动力学变化及意义。方法 随机选取兔 1 2只 ,采用BIM Ⅱ型生物撞击机致成BCT模型 ,分别在伤前、伤后 2、4、8、2 4h测定甲状腺素 (T3、T4 )、促甲状腺激素 (TSH)、肾素 血管紧张素 AⅠ、AⅡ、胰岛素及C 肽含量 ,并监测血流动力学改变。结果 BCT后 2 4hT3、T4 、TSH分别由伤前的 (1 .43± 0 .62 )nmol/L、(55 .2 0± 1 4 .60 )nmol/L、(8.34± 4 .30 )mU/L降为 (0 .54± 0 .2 8)nmol/L(P <0 .0 1 )、(32 .50± 2 .70 )nmol/L(P <0 .0 1 )、(2 .2 4± 0 .79)mU/L(P <0 .0 1 ) ;AⅠ、AⅡ、胰岛素和C肽分别由伤前的(0 .44± 0 .2 5) μg·L- 1 ·h- 1 、(48.0± 1 0 .9)ng/L、(5 .96± 2 .66)mIU/L、(0 .2 3± 0 .1 6)nmol/L增高至 (1 .38± 0 .88) μg·L- 1 ·h- 1 (P <0 .0 5)、(70 .0± 9.9)ng/L(P <0 .0 5)、(7.92± 3 .2 2 )mIU/L(P <0 .0 5)、(0 .52± 0 .0 9)nmol/L(P <0 .0 5) ;左室舒张末压 (LVEDP)和左室内压最大下降速率( dp/dtmax)增高 ;相关分析表明血清甲状腺激素、肾素 血管紧张素、胰岛素及C肽含量改变与血流动力学变化呈明显相关 (P <0 .0 5、P <0 .0 1 )。结论 BCT后体内部分激素明显改变是引起心功能障碍的原因之一。

Objective To explore the changes and the significance of the hemodynamics and some hormones in plasma after blunt chest trauma (BCT) in rabbits.Methods Using the model of BCT induced by BIM Ⅱ Bio impactor in 12 rabbits, the changes of the hemodynamics and some hormones in plasma at pre injury, 2?h, 4?h, 8?h and 24?h post injury were observed. Results The contents of plasma T3, T4, TSH were progressively decreased at 24?h post BCT from (1.43±0.62)?nmol/L,(55.20±14.60)?nmol/L,(8.34±4.30)?mU/L pre injury to (0.54±0.28)?nmol/L (P<0.01),(32.50± 2.70) ?nmol/L (P<0.01),(2.24±0.79)?mU/L (P<0.01),respectively. The contents of AⅠ, AⅡ, insulin and C peptide were increased from (0.44±0.25)?μg·L -1 ·h -1 ,(48.0±10.9)?ng/L,(5.96± 2.66) ?mIU/L,(0.23±0.16)?nmol/L pre injury to (1.38±0.88)?μg·L -1 ·h -1 (P<0.05),(70.0± 9.9) ?ng/L (P<0.05),(7.92±3.22)?mIU/L (P<0.05) and (0.52±0.09)?nmol/L(P< 0.05), respectively. The LVEDP and dp/dtmax were increased (P<0.01 and P<0.05) respectively. The correlation analysis revealed that the changes of hormones were related with hemodynamics markedly ( P < 0.05 and P<0.05, respectively).Conclusion Some hormones in plasma markedly changed after BCT in rabbits, which might be one of the causes of the cardiac dysfunction after BCT.