Feng Yong-Qiang, Wang De-Chang, Wang Kun, Leng Xiang-Feng, Xiao Hu, Guo Dan-Feng
Department of Burns and Plastic Surgery, Provincial Hospital Affiliated to Shandong University, Ji'nan 250021, China.
Zhonghua Shao Shang Za Zhi. 2011 Feb;27(1):49-53.
To investigate the role of lymphatics in bacterial translocation from intestine of rats with burn.
Escherichia coli (E. coli) labeled with chloromethylbenzamidodialkylcarbocyanine (CM-DIL) were prepared. Sixty adult male Wistar rats were randomly divided into scald group and sham injury group according to the envelope method, with 30 rats in each group. Rats in both groups were gavaged with 0.5 mL fluid containing CM-DIL-labeled E. coli. Rats in scald group were inflicted with 30% TBSA deep partial-thickness scald (verified by pathological section) and resuscitated with fluid. Rats in sham injury group were sham injured by bathing in 25 degrees C water for 10 s (verified by pathological section) and also received with fluid infusion. Mesenteric lymph node (MLN), liver, mesenteric lymph fluid (MLF), and liver vein blood (LVB) were harvested at post injury hour (PIH) 2, 24, and 72. Bacteria translocation was detected with fluorescent tracing technique and bacteria culture. The endotoxin content in above-mentioned four kinds of specimens was quantitatively determined with chromogenic substrate limulus amebocyte lysate. The carrying capacity of endotoxin in MLF and LVB was calculated. Data were processed with t test or one-way analysis of variance.
(1) Living bacteria were in short-stick form, and they were seen moving in single or in doubles or triples in sample fluid. Dead bacteria were in irregular aggregates. Labeled bacteria in small amount were detected in sham injury group, their number peaked at PIH 24. A large amount of labeled bacteria were detected in scald group at PIH 2, which peaked at PIH 24 and decreased at PIH 72. The largest amount of labeled bacteria were found in MLN in scald group as compared to those in the other samples, and the number peaked at PIH 24 [(5872 +/- 1976) x 10(3) CFU/g], which was obviously higher than that [(216 +/- 110) x 10(3) CFU/g, t = 30.129, P = 0.000] in sham injury group. The number of bacteria decreased at PIH 72, but it was still significantly different from that in sham injury group ( t = 4.323, P = 0.000). The number of bacteria in LVB was the smallest. (2) 29 (24.2%) samples out of the 120 samples in sham injury group were positive for bacteria. 72 (60.0%) samples out of the 120 samples in scald group were positive for bacteria. No alive bacterium was detected at any time point in LVB sample in both group; the other three samples were detected with alive bacteria since PIH 2. There were more alive bacteria detected in MLN and liver as compared with the other two kinds of samples in scald group. The amount of bacteria in MLN, liver, and MLF in scald group were higher than those in sham injury group (with t value respectively 4.353, 4.354, 4.965, P values all equal to 0.000). (3) The endotoxin level in each kind of sample at each time point was obviously higher in scald group than that in sham injury group, and it peaked at PIH 2 in liver and MLF. The difference of endotoxin level among 4 kinds of samples in scald group at PIH 2 was statistically significant ( F = 258.47, P = 0.000), and the endotoxin level was higher in liver, MLN, and MLF. They were obviously higher than those in sham injury group (with t value respectively 43.378, 43.123, 22.423, P values all equal to 0.000). The endotoxin level in MLF was 9 times of that in LVB. (4) The carrying capacity of endotoxin in LVB and MLF at each time point in scald group was higher than that in sham injury group.
CM-DIL marked bacteria can reflect the microbial translocation condition. The lymphatic route is an important pathway for bacteria translocation.
探讨淋巴管在烧伤大鼠肠道细菌移位中的作用。
制备用氯甲基苯甲酰二烷基碳菁(CM-DIL)标记的大肠杆菌(E. coli)。60只成年雄性Wistar大鼠按信封法随机分为烫伤组和假伤组,每组30只。两组大鼠均灌胃0.5 mL含CM-DIL标记大肠杆菌的液体。烫伤组大鼠给予30%总体表面积深度Ⅱ度烫伤(经病理切片证实)并补液复苏。假伤组大鼠于25℃水中浸浴10 s造成假伤(经病理切片证实),同样给予液体输注。于伤后2、24和72小时采集肠系膜淋巴结(MLN)、肝脏、肠系膜淋巴液(MLF)和肝静脉血(LVB)。采用荧光示踪技术和细菌培养检测细菌移位。用显色基质鲎试剂定量测定上述四种标本中的内毒素含量。计算MLF和LVB中内毒素的携带量。数据采用t检验或单因素方差分析处理。
(1)活菌呈短杆状,在样本液中可见单个、成双或三个一起移动。死菌呈不规则聚集体。假伤组检测到少量标记菌,其数量在伤后24小时达到峰值。烫伤组在伤后2小时检测到大量标记菌,在伤后24小时达到峰值,伤后72小时减少。烫伤组MLN中标记菌数量最多,与其他样本相比,伤后24小时数量达到峰值[(5872±1976)×10³CFU/g],明显高于假伤组[(216±110)×10³CFU/g,t = 30.129,P = 0.000]。伤后72小时细菌数量减少,但仍与假伤组有显著差异(t = 4.323,P = 0.000)。LVB中细菌数量最少。(2)假伤组120个样本中有29个(24.2%)细菌检测阳性。烫伤组120个样本中有72个(60.0%)细菌检测阳性。两组LVB样本在任何时间点均未检测到活菌;其他三个样本自伤后2小时起检测到活菌。烫伤组MLN和肝脏中检测到的活菌比其他两种样本多。烫伤组MLN、肝脏和MLF中的细菌数量高于假伤组(t值分别为4.353、4.354、4.965,P值均等于0.000)。(3)烫伤组各时间点每种样本中的内毒素水平均明显高于假伤组,且在伤后2小时肝脏和MLF中达到峰值。烫伤组伤后2小时四种样本间内毒素水平差异有统计学意义(F = 258.47,P = 0.000),肝脏、MLN和MLF中的内毒素水平较高。它们明显高于假伤组(t值分别为43.378、43.123、22.423,P值均等于0.000)。MLF中的内毒素水平是LVB中的9倍。(4)烫伤组各时间点LVB和MLF中内毒素的携带量高于假伤组。
CM-DIL标记细菌可反映微生物移位情况。淋巴途径是细菌移位的重要途径。