Huang Yuesheng, Li Zhiqing, Yang Zongcheng
Institute of Burn Research, Southwestern Hospital, Third Military Medical University, 400038, Chongqing, PR China.
Burns. 2003 Dec;29(8):828-33. doi: 10.1016/s0305-4179(03)00204-3.
To evaluate the roles of ischemia and hypoxia in the development of post-burn cardiac shock and its molecular pathogenesis.
One hundred and fifty healthy adult Wistar rats were divided into the control group and burn group inflicted with 30% total body surface area third degree burn. Groups were processed at 1, 3, 6, 12 and 24h post-burn. Myocardial contractile function, myocardial microvascular permeability, volume of regional myocardial blood flow, levels of myocardial myosin light chain 1 (CM-LC1), myocardial NF-kappaB (nuclear factor kappa B) activity, MPO (myeloperoxidase), TNFalpha (tumor necrosis factor alpha) mRNA expression and levels of myocardial TNFalpha were measured.
Myocardial microvascular permeability began to rise at 1h post-burn and was still rising at 24h (2.1 times as high as that of the control group); the volume of regional myocardial blood flow fell significantly and remained at a level markedly lower than that in the control group; CM-LC1 also rose significantly and reached a level 18.6 times as high as that in the control group; myocardial NF-kappaB activity and TNFalpha mRNA expression were significantly promoted; elevation of levels of myocardial TNFalpha and MPO activity occurred; cardiac mechanic parameters including LVSP, +/-dp/dt max significantly decreased while LVEDP increased.
The findings of the present study suggest severe myocardial damage due to ischemia and hypoxia following burns; promotion of myocardial NF-kappaB activity and TNFalpha mRNA expression in myocardium may be an important factor in the development of post-burn cardiac shock.
评估缺血和缺氧在烧伤后心源性休克发生发展中的作用及其分子发病机制。
将150只健康成年Wistar大鼠分为对照组和烧伤组,烧伤组给予30%总体表面积的Ⅲ度烧伤。在烧伤后1、3、6、12和24小时对各组进行处理。测量心肌收缩功能、心肌微血管通透性、局部心肌血流量、心肌肌球蛋白轻链1(CM-LC1)水平、心肌核因子κB(NF-κB)活性、髓过氧化物酶(MPO)、肿瘤坏死因子α(TNFα)mRNA表达及心肌TNFα水平。
烧伤后1小时心肌微血管通透性开始升高,24小时仍在升高(是对照组的2.1倍);局部心肌血流量显著下降,且一直维持在明显低于对照组的水平;CM-LC1也显著升高,达到对照组的18.6倍;心肌NF-κB活性和TNFα mRNA表达显著增强;心肌TNFα水平升高,MPO活性增强;包括左室收缩压(LVSP)、±dp/dt max在内的心脏力学参数显著降低,而左室舒张末压(LVEDP)升高。
本研究结果提示烧伤后缺血缺氧可导致严重心肌损伤;心肌NF-κB活性增强和TNFα mRNA表达上调可能是烧伤后心源性休克发生发展的重要因素。