闫柏刚 黄跃生 杨宗城 黎鳌 400038 重庆， 第三军医大学西南医院烧伤研究所 中华整形烧伤外科杂志 1999 0 15 2


    关键词：烧伤；心肌损伤；切痂 期刊 zhzxsswkzz 0 论 著 fur -->


    

【摘要】 目的 探讨早期一次性切痂对烧伤后心肌损伤的防治作用。方法 建立30%TBSAⅢ度烧伤大鼠立即切痂模型，动物随机分为正常对照组、未切痂组和切痂组，于伤后1，3，6，12和24h检测血浆肌钙蛋白T(TnT)和肿瘤坏死因子(TNF)等指标。结果 烧伤后3h血浆TnT即显著升高，伤后6h血浆TNF显著高于伤前，心肌组织中TNF也在伤后12h显著升高。未切痂组与切痂组比较，伤后1～3h未切痂组TnT、TNF略低于切痂组，烧伤6h后，未切痂组TnT显著高于切痂组，烧伤12h后，未切痂组TNF显著高于切痂组。TNF与TnT存在显著正相关关系。结论 TNF是引起烧伤后心肌损伤的重要因素，且与心肌损伤程度密切相关。伤后即行一次性切痂可以减少炎症介质的生成和释放，这可能是其对烧伤后并发心肌损伤具有防治作用的机理之一。

    

The protective effects ofprompt escharectomy on myocardial injury following burn in rats

YAN Baigang, HUANG Yuesheng, YANGZongcheng, et al.

    Institute of Burn Research, Southwestern Hospital, Third Military Medical University,Chongqing, 400038

【 Abstract 】 Objective Toinvestigate the protective effects of prompt escharectomy on myocardial injury followingsevere burns.Methods Rats were inflicted with 30% TBSA Ⅲ degree scald.They were randomlydivided into 3 groups:control group (C,n=10),non-escharectomy group (NE,n=50),escharectomygroup (E,n=50).In the E group,burn wounds were excised promptly after the injury.Thelevels of troponin T (TnT) and tumor necrosis factor (TNF) in plasma and TNF in myocardiumwere measured at 1, 3, 6, 12 and 24 hours postburn.Results TnT levelsincreased markedly at 3 hours post burn,plasma TNF levels increased markedly at 6 hourspostburn, and TNF levels in myocardium also increased markedly at 12 hours postburncompared with the C group.Although the levels of TnT and TNF were a little lower in NEgroup than those in E group at 3 hours post burn,the levels of TnT 6 hours postburn andlevels of TNF 12 hours postburn were significantly higher in NE group than those in Egroup.There were good positive correlations between TNF with TnT levels.Conclusions TNF played important roles in the pathogenesis of myocardial injury followingburns,its level was correlated with the severity of myocardial injury.TNF levels in Egroup was much lower that in NE group,suggesting that prompt escharectomy could reduce theproduction and release of inflammatory cytokines, and lessen the myocardial injury inducedby uncontrolled inflammatory response.

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