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[创伤后多器官功能衰竭中铁与铁蛋白的变化]

[Iron and ferritin changes in multiple organs failure after trauma].

作者信息

Wang Dian, Yang Tian-Tong, Yu Wen, Yu Xiao-Jun, Wang Hai-Peng, Wang Guang-Huan

机构信息

Department of Forensic Science, Medical College, Shantou University, Shantou 515041, China.

出版信息

Fa Yi Xue Za Zhi. 2011 Jun;27(3):169-73.

Abstract

OBJECTIVE

To investigate the changes of iron content in serum and liver, ferritin content in serum, percentage of myeloperoxidase (MPO) positive granulocyte in rabbits after different serious trauma and to explore the relationship between these changes and multiple organ failure (MOF).

METHODS

Rabbit trauma models were established. Iron content in serum and liver, ferritin content in serum and the percentage of MPO positive granulocyte were measured at different time after trauma.

RESULTS

After trauma, iron content in serum decreased sharply in early period (12-36h) and increased gradually to normal level in mild traumatic group after 60 h. Iron content in serum remained lower level in severe traumatic and death group 60 h after trauma. Iron content in liver obviously increased in death group. The changes of ferritin content in serum in mild traumatic were not obvious. Ferritin contents in serum in severe injury group and death group were slightly higher in early period and decreased in later period. The percentage of MPO positive granulocyte increased in early period after trauma. The percentage began to decrease 6 d after trauma and returned to normal level in mild traumatic group. The percentage obviously was significantly lower than normal levels in severe traumatic group and death group 6 d after trauma. Some rabbits died 60 h-6 d after severe trauma, and the pathological changes in the other organs were consistent with MOF.

CONCLUSION

Trauma can cause the serum iron, ferritin levels and percentage of MPO positive granulocyte changes. Severe trauma can cause uncompensated changes of these indicators, which could be the main mechanisms of MOF and death.

摘要

目的

探讨不同严重创伤后家兔血清和肝脏铁含量、血清铁蛋白含量、髓过氧化物酶(MPO)阳性粒细胞百分比的变化,并探讨这些变化与多器官功能障碍综合征(MOF)之间的关系。

方法

建立家兔创伤模型。于创伤后不同时间点测定血清和肝脏铁含量、血清铁蛋白含量及MPO阳性粒细胞百分比。

结果

创伤后,轻度创伤组血清铁含量在早期(12 - 36小时)急剧下降,60小时后逐渐升至正常水平。严重创伤组和死亡组创伤后60小时血清铁含量仍处于较低水平。死亡组肝脏铁含量明显升高。轻度创伤组血清铁蛋白含量变化不明显。重度损伤组和死亡组血清铁蛋白含量在早期略有升高,后期下降。创伤后早期MPO阳性粒细胞百分比升高。创伤6天后该百分比开始下降,轻度创伤组恢复至正常水平。创伤6天后,重度创伤组和死亡组该百分比明显低于正常水平。部分家兔在严重创伤后60小时至6天死亡,其他器官的病理变化符合MOF。

结论

创伤可导致血清铁、铁蛋白水平及MPO阳性粒细胞百分比发生变化。严重创伤可导致这些指标出现失代偿性变化,这可能是MOF及死亡的主要机制。

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