两种复合战伤合并海水浸泡对血管内皮细胞损伤的比较研究

Comparison of the effect of seawater immersion on endothelial cells in rats with burn-firearm combined injury and burn-blast combined injury

目的 比较两种复合战伤 (烧冲复合伤和弹烧复合伤 )合并海水浸泡对血管内皮细胞影响的特点和机制。方法 建立烧冲、弹烧复合伤的犬实验模型 ,将实验犬按致伤类型随机分为两组 ,即烧冲复合伤组和弹烧复合伤组 ,各 2 0只。致伤后置入海水中浸泡 ,4 h后捞出 ,于伤前、伤后 4 ,7,10 ,2 0和 2 8h分别取血检测循环内皮细胞 (CEC)和血管性假血友病因子 (v WF)。结果 (1) CEC计数 :烧冲伤合并海水浸泡在伤后 4 h明显增加 ,伤后 7h为 6个时相点的最高值 ,之后呈缓慢下降趋势 ;而弹烧伤合并海水浸泡在伤后 4 h明显增加 ,之后随时间延长呈加重趋势 ,在伤后 2 8h达最高峰值。伤后 4 ,7,2 0和 2 8h烧冲伤与弹烧伤的 CEC变化相比差异有非常显著性 (P<0 .0 1)。 (2 ) v WF:烧冲伤合并海水浸泡在伤后 4 h为 6个时相点的最高值 ,而弹烧伤合并海水浸泡在伤后 2 8h才达到峰值。伤后 4 ,2 0和 2 8h烧冲伤与弹烧伤的v WF变化差异有显著性 (P<0 .0 5或 0 .0 1)。结论 烧冲复合伤合并海水浸泡对 CEC损伤的峰值一般在伤后 4 h或 7h;弹烧复合伤合并海水浸泡对 CEC损伤的峰值延后 ,一般在伤后 2 0 h或 2 8h。

Objective To compare the influence and mechanism of seawater immersion on endothelial cells in rats with burn-firearm combined injury and burn-blast combined injury.Methods The dog models of burn-blast combined injury and burn-firearm combined injury were developed.The dogs were randomly divided into two groups:burn-blast combined injury group and burn-firearm combined injury group.Immersed in seawater for 4 hours after being injured,the dogs were taken out.Blood samples were withdrawn from central vein before injury,4,7,10,20 and 28 h after injury to measure circulating endothelial cells (CEC),and von Willebrand Factor (vWF).Results (1) CEC:CEC were significantly increased in burn-blast combined injury group at 4 h after injury,and the peak of CEC was at 7 h after injury;CEC were significantly increased in burn-firearm combined injury group at 4 h after injury,and the peak of CEC was at 28 h after injury.The change of CEC in burn-blast combined injury group was significantly different from that in the burn-firearm combined injury group at 4,7,20,28 h after injury( P <0.01).(2) vWF:The peak of vWF in burn-blast combined injury group was at 4 h after injury;while the peak of vWF in burn-firearm combined injury group was at 28 h after injury.The change of vWF in burn-blast combined injury group was significantly different from that in burn-firearm combined injury group at 4 h,20 h,28 h after injury( P <0.05 or 0.01).Conclusions The peak injury of seawater immersion on endothelial cells in burn-blast combined injury group occurred at 4 h or 7 h after injury;and the peak injury of seawater immersion on endothelial cells in burn-firearm combined injury group occurred at 20 h or 28 h after injury.