[强化胰岛素治疗对严重烫伤大鼠心肌的保护作用]
[The protective effect of intensive insulin treatment on the myocardium in severely scalded rats].
作者信息
Lv Gen-Fa, Chen Bi, Zhang Wan-Fu, Wang Yun-Chuan, Cai Wei-Xia, Tang Chao-Wu, Zhu Xiong-Xiang, Dong Mao-Long, Hu Da-Hai
机构信息
Center of Burn Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, PR China.
出版信息
Zhonghua Shao Shang Za Zhi. 2007 Jun;23(3):168-71.
OBJECTIVE
To study the protective effect of intensive insulin treatment on the myocardium of severely scalded rats, and to primarily explore its mechanism.
METHODS
Eighteen SD rats were divided into three groups, with 6 rats in each group. The rats in burn and intensive insulin group were inflicted with 30% TBSA full-thickness injury on the back. Isotonic saline containing 0.12 U/ml insulin solution, and 100 g/L glucose solution were infused into the rats in the intensive insulin group to keep plasma glucose at the level of 4.0 - 6.6 mmol/L (the total fluid amount was 2 ml x kg(-1) x 8h(-1)). In sham burn group,fluid was given according to physiological demand. The same amount of isotonic saline was infused into the rats in burn group. The venous blood was obtained for the detection of plasma glucose contents, and the left ventricular systolic pressure (LVSP) and left ventricular end-diastolic pressure (LVEDP) were recorded via aortic ventricle cannula before scald and at 1, 2, 3, 4, 5, 6 post-scald hours (PSH). The tissue of the left ventricle was harvested at 6 PSH for the detection of troponin T expression in myocardiocytes.
RESULTS
Plasma glucose level was increased to (7.6 +/- 1.7) mmol/L - (8.4 +/- 4.7) mmol/L in burn group during 1-6 PSH, which was significantly higher than that in intensive insulin group (4.5 +/- 0.9) mmol/L - (5.2 +/- 1.3) mmol/L, P < 0.01). Compared with the intensive insulin group, LVSP was markedly decreased in the burn group (60 +/- 11 mm Hg vs 72 +/- 8 mm Hg, P < 0.05) at 1 PSH,whereas LVEDP was increased significantly (21.3 +/- 11.3 mmHg vs 11.7 +/- 5.2 mmHg, P < 0.05). Intensive insulin treatment could significantly inhibit the loss of troponin T protein in myofilaments of myocardium.
CONCLUSION
Intensive insulin treatment possesses a protective effect on myocardia function after severe burns, and it may be related to its preventive effect on the loss of contractile protein in cardiocytes.
目的
研究强化胰岛素治疗对重度烫伤大鼠心肌的保护作用，并初步探讨其机制。
方法
将18只SD大鼠分为三组，每组6只。烧伤及强化胰岛素组大鼠背部造成30%总体表面积的全层损伤。向强化胰岛素组大鼠输注含0.12 U/ml胰岛素溶液的等渗盐水及100 g/L葡萄糖溶液，使血浆葡萄糖维持在4.0 - 6.6 mmol/L水平（总液体量为2 ml·kg⁻¹·8h⁻¹）。假烧伤组按生理需求给予液体。烧伤组大鼠输注等量的等渗盐水。于烫伤前及烫伤后1、2、3、4、5、6小时（PSH）经主动脉心室插管采集静脉血检测血浆葡萄糖含量，记录左心室收缩压（LVSP）和左心室舒张末期压力（LVEDP）。于烫伤后6小时采集左心室组织，检测心肌细胞肌钙蛋白T表达。
结果
烧伤组在烫伤后1 - 6小时血浆葡萄糖水平升高至（7.6±1.7）mmol/L - （8.4±4.7）mmol/L，显著高于强化胰岛素组（4.5±0.9）mmol/L - （5.2±1.3）mmol/L，P < 0.01）。与强化胰岛素组相比，烧伤组在烫伤后1小时LVSP显著降低（60±11 mmHg对72±8 mmHg，P < 0.05），而LVEDP显著升高（21.3±11.3 mmHg对11.7±5.2 mmHg，P < 0.05）。强化胰岛素治疗可显著抑制心肌肌丝中肌钙蛋白T蛋白的丢失。
结论
强化胰岛素治疗对重度烧伤后心肌功能具有保护作用，可能与其预防心肌细胞收缩蛋白丢失有关。
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