大鼠严重烫伤后合理应用外源性糖皮质激素进行救治的实验研究

Reasonable usage of ectogenous glucocorticoids for the management of severely scalded rats

目的 研究不同时间应用不同剂量地塞米松对严重烫伤大鼠血清TNF α、IL 1β和IL 6的影响 ,为临床上合理应用外源性糖皮质激素 (GC)救治严重创伤患者提供实验依据。方法 于严重烫伤后早期 48h内不同时间分别给大鼠腹腔注射 5mg kg(大剂量 )和 0 .5mg kg(小剂量 )地塞米松 ,应用ELISA方法检测血清TNF α、IL 1β和IL 6的含量改变。 结果烫伤后 4h和 12h应用大、小剂量地塞米松均可显著降低血清中TNF α、IL 1β、IL 6的含量 ,其中大剂量效果更加显著 ;烫伤后 2 4h应用大、小剂量地塞米松均可显著降低IL 1β、IL 6的含量 ,但两种剂量间无显著差别 ;烫伤后 48h用不同剂量地塞米松对三种细胞因子的影响均不显著。结论 从对炎性细胞因子的影响来看 ,严重烫伤后 4～ 12h应用大剂量外源性GC ,12～ 2 4h应用小剂量GC ,可产生最佳救治效果。

Objective To investigate the effects of different doses of dexamethasone used at different time on the serumal concentrations of TNF α, IL 1β and IL 6 of rats after severe scald in order to provide experimental basis for reasonable usage of ectogenous glucocorticoids for severe traumas. Methods The serumal concentrations of TNF α, IL 1β and IL 6 were detected by ELISA after intraperitoneal injection of different doses of dexamethasone into rats at different time after severe scald. Results High dose(5 mg/kg) and low dose (0.5 mg/kg) of dexathemasone used during the period from 4 h to 12 h after severe scald could both significantly reduce the serumal concentrations of TNF α, IL 1β and IL 6, and the effect of high dose was much better than that of low dose. Both doses of dexathemasone used at 24 h after scald had a significant effect on IL 1β and IL 6, but there was no difference between the two doses. No obvious effects were found of high/low dose of dexamethasone used 48 h later after scald. Conclusion According to the anti inflammatory effect, the best therapeutic efficacy may result from high dose of ectogenous glucocorticoids during the period from 4 h to 12 h and low dose from 12 h to 24 h after severe scald.