Zhang Xiao-Jun, Meng Chengyue, Chinkes David L, Finnerty Celeste C, Aarsland Asle, Jeschke Marc G, Herndon David N
Shriners Hospital for Children, Galveston, TX, USA.
Surgery. 2009 May;145(5):558-67. doi: 10.1016/j.surg.2009.01.006. Epub 2009 Mar 21.
Propranolol administration has been demonstrated to improve cardiac work, decrease energy expenditure, and attenuate lipolysis in burned patients; however, its effect on wound healing has not been reported.
In rabbits, a partial-thickness skin donor site wound was created on the back, and catheters were placed in the carotid artery and jugular vein. A nasogastric feeding tube was placed for enteral feeding. On day 5 after injury, stable isotope tracers were infused to determine protein and DNA kinetics in the wound. Propranolol hydrochloride was injected in 1 group during the tracer infusion to decrease heart rate, and the other group without propranolol injection served as a control.
The propranolol infusion decreased heart rate by 21%. The protein fractional synthetic rate in the wound was greater in the propranolol group (8.6 +/- 0.9 vs 6.1 +/- 0.5%/day, P < .05). Wound protein fractional breakdown rates were not significantly different. The rate of protein deposition (synthesis - breakdown) was increased in the propranolol group (5.0 +/- 1.2 vs 2.8 +/- 0.7%/day, P = .07). Wound DNA fractional synthetic rates were comparable. The protein fractional synthetic rate was correlated with percent decrease in heart rate, but expression of the beta-adrenergic receptors and downstream signaling cascades in local wounds were not affected after propranolol treatment.
Propranolol infusion increased wound protein synthetic rate and tended to increase wound protein deposition rate, which might be beneficial to wound healing. These changes might reflect a systemic response to the beta-adrenergic blockade.
已证明给予普萘洛尔可改善烧伤患者的心脏做功、降低能量消耗并减轻脂肪分解;然而,其对伤口愈合的影响尚未见报道。
在兔背部制造一个部分厚度的皮肤供区伤口,并将导管置入颈动脉和颈静脉。放置鼻胃饲管进行肠内喂养。在受伤后第5天,输注稳定同位素示踪剂以测定伤口中的蛋白质和DNA动力学。在一组示踪剂输注期间注射盐酸普萘洛尔以降低心率,另一组未注射普萘洛尔作为对照。
普萘洛尔输注使心率降低了21%。普萘洛尔组伤口中的蛋白质分数合成率更高(8.6±0.9对6.1±0.5%/天,P<0.05)。伤口蛋白质分数分解率无显著差异。普萘洛尔组蛋白质沉积率(合成 - 分解)增加(5.0±1.2对2.8±0.7%/天,P = 0.07)。伤口DNA分数合成率相当。蛋白质分数合成率与心率降低百分比相关,但普萘洛尔治疗后局部伤口中β-肾上腺素能受体的表达和下游信号级联反应未受影响。
普萘洛尔输注增加了伤口蛋白质合成率,并倾向于增加伤口蛋白质沉积率,这可能有利于伤口愈合。这些变化可能反映了对β-肾上腺素能阻断的全身反应。