Department of Clinical Laboratory, The 94th Hospital of PLA, Nanchang 330002, Jiang Xi, China.
Burns. 2012 Sep;38(6):846-54. doi: 10.1016/j.burns.2011.12.015. Epub 2012 Feb 15.
Intestinal barrier damage after scald and burns, other trauma or major operations result in severe intestinal infections that cause serious consequences. Therefore, it is important to develop methods to protect intestinal barrier after severe burns. This study used rats that had full-thickness burn of approximately 30% of the total body surface area to investigate the effect and mechanism of glucose-insulin-potassium (GIK) and provide experimental evidence for application of GIK in protecting the intestine after burns or other trauma and major surgeries. The results show that the degree of intestinal damage and plasma diamine oxidase (DAO) levels in GIK (the concentrations of glucose, insulin, sodium chloride and potassium chloride were 100 g l(-1), 70 U l(-1), 9 g l(-1) and 5 g l(-1), respectively) and insulin (30 IU l(-1)) treatment groups were significantly lower than that in control group; the status of anti-inflammatory and pro-inflammatory cytokines and the ratio between them in GIK and insulin groups also significantly improved compared to those in control group; intestinal tumour necrosis factor-alpha (TNFα), nuclear factor-kappaB (NF-κB) and interleukin-10 (IL-10) messenger RNA (mRNA) expression and IL10/TNFα in GIK and insulin groups 2 days after the injury were also improved significantly compared to those in control group. All the indices including body weight detected in GIK group were improved to those in insulin group. Taken together, these results show that GIK and insulin show protective effect on intestine after severe burn, which may relate to controlling hyperglycaemia and regulating intestinal expression of NFκB and pro-inflammatory and anti-inflammatory cytokine genes by GIK and insulin; the protective effect of GIK on intestinal tissue after severe burn is superior to that of using insulin alone, which may attribute to improving the nutritional status by glucose supplement and the relatively higher dose of insulin in the GIK group.
烫伤和烧伤、其他创伤或大手术后的肠道屏障损伤会导致严重的肠道感染，从而造成严重后果。因此，开发严重烧伤后保护肠道屏障的方法非常重要。本研究使用大鼠全身体表面积约 30%的Ⅲ度烧伤模型，探讨葡萄糖-胰岛素-钾（GIK）的作用和机制，为 GIK 在烧伤或其他创伤和大手术后保护肠道提供实验依据。结果表明，GIK（葡萄糖、胰岛素、氯化钠和氯化钾浓度分别为 100g/L、70U/L、9g/L 和 5g/L）和胰岛素（30IU/L）治疗组的肠道损伤程度和血浆二胺氧化酶（DAO）水平明显低于对照组；GIK 和胰岛素组抗炎和促炎细胞因子的状态及其比值也明显优于对照组；GIK 和胰岛素组肠道肿瘤坏死因子-α（TNF-α）、核因子-κB（NF-κB）和白细胞介素-10（IL-10）信使 RNA（mRNA）表达及 IL10/TNFα在伤后 2 天也明显改善。GIK 组检测到的体重等各项指标均恢复到胰岛素组水平。综上所述，GIK 和胰岛素对严重烧伤后肠道具有保护作用，这可能与 GIK 和胰岛素通过控制高血糖、调节 NFκB 和促炎及抗炎细胞因子基因的肠道表达有关；GIK 对严重烧伤后肠道组织的保护作用优于单独使用胰岛素，这可能归因于葡萄糖补充改善营养状态和 GIK 组胰岛素的相对较高剂量。
