方文慧 姚咏明 施志国 于燕 吴叶 郑玉清

    方文慧 姚咏明 施志国 于燕 郑玉清 北京，解放军第三○四医院创伤外科中心 100037；吴叶 解放军第二○八医院外四科 中华整形烧伤外科杂志 1999 0 15 4


    关键词：烧伤；内毒素移位；多脏器功能障碍综合征 期刊 zhzxsswkzz 0 论著 fur -->


    

【摘要】 目的 观察烫伤后肠源性内毒素的组织分布特点及其与器官功能损害的关系。方法 采用大鼠35%Ⅲ度烫伤模型，分别于伤前，伤后12，24，48，72h活杀动物。留取组织或血标本，分别检测组织内毒素的含量及器官功能指标。结果 烫伤后肝、脾、肺组织内毒素含量明显增高，其中以肝组织升高幅度最大。同时，伤后血清谷丙转氨酶(ALT)、谷草转氨酶(AST)、心肌型肌酸激酶同工酶(CK-MB)水平及肺组织髓过氧化物酶(MPO)活性均显著增高(P<0.01)，且一直持续至伤后24h；而小肠组织二胺氧化酶(DAO)活性呈持续降低趋势。相关分析表明，肺、肾组织内毒素含量分别与肺组织MPO活性及血清肌酐(Cr)水平呈显著正相关(P<0.05)。结论 烫伤早期肠道内毒素移位并聚积于局部组织中，且持续较长时间，组织内毒素在诱导器官功能损害中可能具有重要意义。

The time course and tissuedistribution of endotoxin in rats after thermal injury

FANG Wenhui,YAO Yongming,SHIZhiguo,et al.Trauma Research Center,304th Hospital of People's Liberation Army,Beijing100037

【 Abstract 】 Objective To observe the time course and tissue distribution ofendotoxin,and to evaluate the potential role of local endotoxin in mediating multipleorgan damage following burns.Methods Wistar rats were subjected to a 35 percent full-thicknessscald injury.They were grouped according to time of sacrifice:no burn,and 12,24,48,72hours postburn.Tissue specimens from liver,kidneys,lungs and intestine were asepticallyharvested to determine tissue endotoxin levels.In addition,blood samples were obtained formeasurement of organ function parameters.Results It was found that endotoxin levels in liver,spleen andlungs increased markedly after thermal injury,with the highest level inliver.Meanwhile,serum GPT,GOT,CK-MB levels,and pulmonary myeloperoxidase(MPO)activitiesmarkedly elevated after scald injury,reaching a maximum between 12 and 24 hours.Intestinaldiamine oxidase(DAO)activities tended to decrease at various time points postburn.Inaddition,there were highly positive correlations between pulmonary endotoxin levels andMPO activities,and also between renal endotoxin levels and serum Cr values.Conclusion Burn injury per se can result ingut-derived endotoxin translocation which is mainly distributed to the liver,spleen andlungs.Endotoxin accumulated in local sites may play an important role in mediatingmultiple organ damage secondary to major burns.

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