严重烧伤大鼠早期切痂植皮对急性期反应的影响及意义

Influence of escharectomy and skin grafting during early burn stage on acute-phase response in severely burned rats and its significance

目的 通过分析严重烫伤大鼠早期切痂植皮后肝脏急性期蛋白的变化 ,探讨早期切痂植皮对急性期反应的影响。方法 采用 30 %Ⅲ度烧伤大鼠模型 ,动物随机分为正常对照组、烧伤后1天切痂组和烧伤后 4天切痂组 ,应用比浊法测定两组大鼠血清α1抗胰蛋白酶 (AT)、α1酸性糖蛋白(AGP)、C 反应蛋白 (CRP)、白蛋白 (Alb)和转铁蛋白 (Trf)浓度变化。结果 两组阳性急性期蛋白与正常组相比均显著升高 (P <0 0 5 ) ,阴性急性期蛋白均显著下降 (P <0 0 5 ) ;烧伤后 1天切痂组AT和AGP浓度在烧伤后 5、7天显著低于烧伤后 4天切痂组 (P <0 0 5 ) ,烧伤后 1天切痂组CRP浓度在烧伤后 4、5、7天显著低于烧伤后 4天切痂组 (P <0 0 5 ) ,烧伤后 1天切痂组白蛋白浓度在烧伤后 7天显著高于烧伤后 4天切痂组 (P <0 0 5 ) ,烧伤后 1天切痂组Trf浓度在烧伤后 5、7天显著高于烧伤后 4天切痂组 (P <0 0 5 )。结论 烧伤后早期切痂植皮可减轻急性期反应 ,对机体有利。

Objective To investigate the influence of escharectomy and skin grafting during early burn stage on the production of acute phase reactants by the liver in severely burned rats. Methods Ninety six Wistar rats were randomly divided into three groups: normal control group (C), escharectomy on postburn day (PBD) 1 group (0) and escharectomy on PBD4 group (F). 30% Ⅲ° (total body surface area full thickness) burn injury was caused by immersing the back in boiling water for 10 seconds. Escharectomy and skin grafting with cryopreserved allogeneic skin were performed one day or 4 days after the burn injury. ON days 1,2,4,5 and 7 after burn injury blood was withdrawn from the abdominal aorta of 8 rats for each experimental group. The serum contents al antitrypsin (AT), al acid glycoprotein (AGP), C reactive protein (CRP), albumin (Alb), and transferring (Trf) were measured by turbidimetry. Results Significant increase in concentrations of positive acute phase reactant, CRP, AGP, and AT, was observed in group O and group F as compared with normal control, ( P < 0 05), while the concentrations of negative acute phase reactants, Alb and Trf, decreased markedly ( P <0 05). The serum concentrations of AT and AGP in group O began to decrease significantly on PBD 5 and PBD7 respectively in comparison with that ofthe group F ( P <0 05), however, they still maitained a rather higher levels on PBD7. The concentration of CRP in group O began to decrease on PBD4, and the values on PBD4, 5, and 7 were significantly lower than those of the group F ( P <0 05). The concentrationof CRP in PBD1 group reached the normal level on PBD7, however, the concentration of CRP in group F kept increasing till PBD5, and remained significantly higher than that in group C ( P <0 05). The concentration of Alb in group O was significantly higher on PBD7 than that in group F( P <0 05). The concentration of Trf in group O on PBD5 and PBD7 was significantly higher than those in group F ( P <0.05). Conclusion Escharectomy and skin grafting during early burn stage attenuates acute phase response after burn injury and are beneficial to the organsim.