早期短程应用亚胺培南在防治大鼠烧伤后肠源性感染中的作用

Early and short-term use of imipenem to prevent bacterial translocation in scalded rats

目的 探讨早期短程应用亚胺培南对严重烫伤大鼠肠道细菌移位的影响及其对脏器功能的保护作用。方法 治疗组采用大鼠 3 5 %～ 40 %Ⅲ度烫伤模型 ,伤后立即静脉注射亚胺培南 ( 4 0mg·kg- 1 ·d- 1 ) ,连续 2d ;同时设正常及烫伤对照组。于 72h活杀动物。留取组织及血标本 ,分别对血液、内脏及肠系膜淋巴结进行细菌定量培养 ,同时检测器官功能指标。结果 治疗组动物肠系膜淋巴结、内脏及血液中细菌移位率明显低于烫伤组 (P <0 .0 5 ) ,且与烫伤组比较血清丙氨酸转氨酶 (ALT)、天门冬氨酸转氨酶 (AST)、尿素氮 (BUN)水平明显下降 (P <0 .0 5 ,P <0 .0 1)。结论 严重烧伤早期短程应用广谱高效的抗生素 (亚胺培南 )能明显降低细菌移位率 ,预防肠源性感染的发生 。

Objective To investigate the effect of early and short term systemic administration of imipenem/cilastatin on the inhibition of bacterial translocation (BT), and the protective effect on early organ function in severely scalded rats. Methods Rats were subjected to a 35% 40% full thickness scald injury of Ⅲ degree. They were randomly divided into normal control group, scalded group and treated group. In the treated group, the scalded rats were immediately administered intravenously by imipenem/cilastatin, 40 mg·kg -1 ·d -1 , twice/day. At 72 h all rats were sacrificed for quantitative bacterial study of liver, kidney, lung, mesenteric lymph nodes (MLNs) and blood samples. In addition, blood samples were obtained for measurement of organ function parameters. Results The incidence of bacterial translocation to MLNs, viscera and blood were reduced significantly in animals treated with imipenem/cilastatin ( P <0.05). Meanwhile, compared with those of the burns group, levels of ALT, AST, BUN in blood serum, and pulmonary myeloperoxidase (MPO) activities markedly declined in the treated group ( P <0.05 to 0.01). Conclusion These data suggest that prophylactic administration of broad spectrum antibiotics is effective to inhibit BT from the gut and to protect the organ function in earlier period of scalded rats.