Hu Quan, Hu Sen, Chai Jia-ke, Shen Xiao-peng, Che Jin-wei, Sheng Zhi-yong
Burns Institute, the First Hospital Affiliated to the PLA General Hospital, Beijing 100048, China.
Zhonghua Shao Shang Za Zhi. 2010 Feb;26(1):41-4.
To study the change in intestinal barrier and organ functions of burned dog after enteral administration of hypertonic electrolyte glucose solution (HEGS) in shock stage.
Twenty-four Beagle dogs inflicted with 35% TBSA full-thickness burn were divided into no-fluid group (NF), intravenous infusion with isotonic electrolyte glucose solution (IEGS) group (II group), enteral infusion with IEGS group (EI), and enteral infusion with HEGS group (EH) according to the random number table, with 6 dogs in each group. Saline, containing 50 g/L glucose, was intravenously or enterally infused into dogs in II group and EI group respectively 0.5 hour post injury (PIH) for resuscitation. Total infusion volume within PIH 24 was 4 mL x kg(-1) x %TBSA(-1) (half of the total volume was infused in the first 8 hours in a constant speed, the other half volume was infused in the rest 16 hours in a constant speed). HEGS, containing 18 g/L NaCl and 50 g/L glucose, was enterally infused into dogs in EH group. Total infusion volume within PIH 24 was 2 mL x kg(-1) x %TBSA(-1), with the same infusion speed as that in II and EI groups. Liver and kidney function indexes [activity of ALT and CK-MB, expression levels of creatinine and blood urea nitrogen (BUN) in serum], activity of diamine oxidase (DAO), and activity of Na(+)-K(+)-ATPase in intestinal mucosa at PIH 24 were determined.
ALT activity in each group was close to one another. Serum levels of creatinine and BUN in II, EI, and EH groups were significantly lower than those in NF group. CK-MB activity obviously increased at PIH 2 in every group. CK-MB activity in EH group at PIH 2 to 8 was respectively lower than that in NF and II groups. DAO activity in serum in II, EI, and EH groups decreased since PIH 4 or PIH 6, respectively from (3.9 + or - 0.6) U/L to (3.6 + or - 0.5) U/L, (4.8 + or - 0.4) U/L to (2.8 + or - 0.8) U/L, (6.4 + or - 1.8) U/L to (3.5 + or - 0.8) U/L, all were significantly lower than those in NF group [from (12.5 + or - 0.4) U/L to (9.7 + or - 1.1) U/L, comparison between EH group and NF group, t value at PIH 4, 6, 8, 24 was respectively 10.25, 12.44, 17.99, 16.21, P values all below 0.05]. The order of Na(+)-k(+)-ATPase activity in intestinal mucosa at PIH 24 in each group from high to low was II group, EH group, EI group, and NF group (comparison between former 3 groups and NF group, t value was respectively 10.09, 4.96, 8.32, F value was 26.79, P values all below 0.05).
HEGS does not cause significant harm to the barrier function of intestinal mucosa of shock dog after burn. Compared with NF, HEGS can significantly improve functions of heart, liver, and kidney, and it can achieve the same resuscitation effect as enteral or intravenous infusion of IEGS with only half of the solution volume.
研究休克期肠内给予高渗电解质葡萄糖溶液（HEGS）后烧伤犬肠屏障及器官功能的变化。
将24只烧伤总面积达35%体表面积的比格犬，按随机数字表法分为不给液组（NF）、静脉输注等渗电解质葡萄糖溶液（IEGS）组（II组）、肠内输注IEGS组（EI）和肠内输注HEGS组（EH），每组6只。伤后0.5小时（PIH）分别对II组和EI组犬静脉或肠内输注含50 g/L葡萄糖的生理盐水进行复苏。伤后24小时内总输注量为4 mL×kg⁻¹×%TBSA⁻¹（前8小时匀速输注总量的一半，后16小时匀速输注另一半）。对EH组犬肠内输注含18 g/L NaCl和50 g/L葡萄糖的HEGS。伤后24小时内总输注量为2 mL×kg⁻¹×%TBSA⁻¹，输注速度与II组和EI组相同。测定伤后24小时肝肾功能指标[血清中ALT和CK - MB活性、肌酐及血尿素氮（BUN）表达水平]、二胺氧化酶（DAO）活性及肠黏膜Na⁺ - K⁺ - ATP酶活性。
各组ALT活性相近。II组、EI组和EH组血清肌酐和BUN水平均显著低于NF组。各组伤后2小时CK - MB活性均明显升高。EH组伤后2至8小时CK - MB活性分别低于NF组和II组。II组、EI组和EH组血清DAO活性分别自伤后4小时或6小时开始下降，分别从（3.9±0.6）U/L降至（3.6±0.5）U/L、（4.8±0.4）U/L降至（2.8±0.8）U/L、（6.4±1.8）U/L降至（3.5±0.8）U/L，均显著低于NF组[从（12.5±0.4）U/L降至（9.7±1.1）U/L，EH组与NF组比较，伤后4、6、8、24小时t值分别为为10.25、12.44、17.99、16.21，P值均<0.05]。伤后24小时各组肠黏膜Na⁺ - K⁺ - ATP酶活性从高到低依次为II组、EH组、EI组、NF组（前3组与NF组比较，t值分别为10.09、4.96、8.32，F值为26.79，P值均<0.05）。
HEGS对烧伤休克犬肠黏膜屏障功能无明显损害。与NF组相比，HEGS能显著改善心、肝、肾功能，且仅用一半的溶液量就能达到与肠内或静脉输注IEGS相同的复苏效果。
