【作者】 余又新；

【导师】 汪昌荣； 方林森； 陈侠英；

【作者基本信息】 安徽医科大学 ， 外科学， 2003， 硕士

【摘要】 目的：初步探讨烟花火药爆炸复合烧伤大鼠心肌损伤及可能机制。 材料与方法：Wistar大鼠128只，随机分为正常对照组(n=8)、烧伤组(n=40)、爆炸伤组(n=40)和复合伤组(n=40)，分别造成大鼠20％体表面积度烧伤、火药爆炸伤和两者复合伤。动态观察大鼠伤后1、3、6、12、24小时血浆CK～MB，心肌组织含水量；心肌细织内皮素(ET)、一氧化氮(NO)、丙二醛(MDA)含量、肿瘤坏死因子α(TNF-α)含量、髓过氧化物酶(MPO)活性；心肌组织光镜、电镜形态学变化；并对各因素之间进行相关分析。 结果：复合伤组较单因素致伤组大鼠血浆CK—MB升高明显，心肌组织水肿加重，心肌组织ET含量、NO含量、MDA含量、MPO活性、TNF-α含量升高，形态学损伤更为明显，而以上因素在烧伤组和爆炸伤组间差异不明显。相关性分析提示CK-MB，ET／NO，MPO，MDA，心肌含水量，TNF-α之间两两均有正相关关系。 结论：1．烧伤、火药爆炸伤、两者复合伤均能引起心肌的损害，复合伤组心肌损伤重于单一伤。2．烟花火药爆炸复合烧伤能引起心肌血供氧供障碍，能量代谢紊乱；心肌中性粒细胞浸润，炎细胞代谢紊乱；氧自由基代谢紊乱；炎症介质(TNF-α)的异常增高等机制导致心肌损害。3．复合伤后心肌ET，NO，MPO，MDA，TNF-α异常增高比单一伤明显。4．烧伤和火药爆炸伤后在以上损伤机制方面的异常无本质差异。更多还原

【Abstract】 Objective: To investigate the injury of cardiac muscle in rats following combined powder explosive and burn injury and its possible pathogenesis. Methods: 128 Wistar rats were randomly divided into four groups which were normal control group (n=8), burn group (n=40), powder explosive group (n=40), combined powder explosive and burn group (n=40). The latter three groups were more divided into 1, 3, 6, 12, 24 hour post injury group, and in each sub group, the animal number is 8. The latter three groups were subjected to 20% total body surface area full thickness burn injury, powder explosive injury and combined powder explosive and burn injury respectively. The following of each group were examined and studied: the CK -MR activities of the blood plasma ,the water contents of the cardiac muscle, the MDA,RT,NO, TNF- a contents and MPO activities in myocardium; the histological and ultrastructural cardiac pathology changes, and correlation analysis were made between each of the two factors.Results: Compared with burn group and powder explosive group, the combined powder explosive and burn group’s CK -MB activities of the blood plasma ,the water contents of the cardiac muscle, ET,NO,MDA, TNF- a contents and MPO activities in the heart, were all elevated significantly, and the histological and ultrastructural cardiac pathology changes were more severe. As to the above several factors, there was no essential difference between burn group and powder explosive group, the relationship between each of the two factors in CK -MB ,ET/NO,MDA, MPO, TNF- a was significance.Conclusions: 1 .The rat’s myocardial injury was obvious after burn, powder explosive, combined powder explosive and burn injury. The degree of combined wound was more severe than the above two single wound. 2.There was myocardiac injury after combined burn and powder explosive injury, It could cause the deficiency of the oxygen and blood supply of the cardiac muscle, the confusion of the energy metabolism, the infiltration of neutrophil in cardiac muscle, the confusion of the oxygen-derived free radicals, the abnormal increase of the inflammation medium(TNF- a ).3.The increase of the ET, NO, MPO, MDA, TNF?a were more obvious after the combined powder explosive and burn injury than single injury.4. As to the above several factors, there was no essential difference between burn group and powder explosive group.更多还原