Zhang Qing-fu, Zhou Hui-min, Wang Che-jiang, Shao Hong-bo
Department of Burns and Plastic Surgery, the First Hospital of Hebei Medical University, Shijiazhuang 050031, China.
Zhonghua Shao Shang Za Zhi. 2012 Jun;28(3):173-7.
To study the influence of high-voltage electric burn on the microcirculation of heart in rabbit.
One-hundred and twenty New Zealand rabbits of clean grade were divided into control group (C) and electric burn group (EB) according to the random number table, with 60 rabbits in each group. Rabbits in EB group were subjected to high-voltage electric burn (the electrical current flow into the left foreleg at the lateral side of proximal end and out from the corresponding site of the right hind leg) with voltage regulator and experimental transformer. Rabbits in C group were sham injured with the same devices without electrification. At 15 minutes before injury, and 5 minutes, 1, 2, 4, 8 hour (s) post injury (PIM or PIH), ten rabbits in each group were chosen to examine the cardiac apex microcirculation hemoperfusion (CAMH) with laser Doppler hemoperfusion image instrument. The morphologic changes of microvessels of left ventricular wall tissues of 2 rabbits from each of the 10 rabbits collected at above-mentioned time points were observed with light microscope and transmission electron microscope. Auricular vein blood of rabbit was harvested at above-mentioned time points for the determination of aspartate amino transferase (AST), lactate dehydrogenase (LDH), hydroxybutyrate dehydrogenase (HBDH), creatine kinase (CK), and creatine kinase isozyme MB (CK-MB) by full-automatic biochemical analyzer. Data were processed with two-factor analysis of variance and LSD test.
(1) The differences between C group and EB group in detection results were statistically significant, with F values from 425.991 to 3046.834, P values all below 0.01. Only the data within EB group were comparable. (2) At PIM 5, the CAMH value of rabbits in EB group was (1.96 ± 0.09) V, which was lower than that at 15 minutes before injury [(4.34 ± 0.35) V, P < 0.01]. The CAMH value of rabbits in EB group was increased at PIH 1 [(3.43 ± 0.30) V], and then it showed a tendency of decrease. (3) Bleeding and microthrombus formation were observed in venule and capillary vessel of rabbits in EB group at PIH 8. Breakage of basement membrane of capillary endothelial cells, mitochondrial swelling, and severe degranulation from damaged endoplasmic reticulum were observed in rabbits of EB group at PIH 8. (4) Levels of AST, LDH, HBDH, CK, and CK-MB in rabbits of EB group were significantly higher at PIH 1, 2, 4, 8 than at 15 minutes before injury (with P values all below 0.01). The AST level peaked at PIH 2 [(164 ± 39) U/L]. Levels of LDH and HBDH peaked at PIH 4, which were respectively (1016 ± 246) U/L and (487 ± 54) U/L. The CK level peaked at PIH 8 [(7799 ± 738) U/L]. The CK-MB level peaked at PIH 2 [(1848 ± 65) U/L].
High-voltage electric burn can bring damage to the microvessels of heart in rabbits and change blood flow of microcirculation, which should be given adequate attention during the treatment.
研究高压电烧伤对兔心脏微循环的影响。
将120只清洁级新西兰兔按随机数字表法分为对照组（C组）和电烧伤组（EB组），每组60只。EB组兔采用电压调节器和实验变压器进行高压电烧伤（电流从左前肢近端外侧流入，从右后肢相应部位流出）。C组兔用相同装置进行假伤，不通电。于伤前15分钟、伤后5分钟、1、2、4、8小时，每组选取10只兔，用激光多普勒血流灌注成像仪检测心尖部微循环血流灌注（CAMH）。取上述时间点每组10只兔中2只兔的左心室壁组织微血管形态学变化，用光镜和透射电镜观察。于上述时间点采集兔耳静脉血，用全自动生化分析仪测定天冬氨酸转氨酶（AST）、乳酸脱氢酶（LDH）、羟丁酸脱氢酶（HBDH）、肌酸激酶（CK）及肌酸激酶同工酶MB（CK-MB）。数据采用两因素方差分析和LSD检验进行处理。
（1）C组与EB组检测结果差异有统计学意义，F值为425.991～3046.834，P值均<0.01。仅EB组内数据具有可比性。（2）伤后5分钟时，EB组兔CAMH值为（1.96±0.09）V，低于伤前15分钟时的（4.34±0.35）V，P<0.01。EB组兔伤后1小时CAMH值升高至（3.43±0.30）V，随后呈下降趋势。（3）伤后8小时，EB组兔微静脉和毛细血管可见出血及微血栓形成。伤后8小时，EB组兔毛细血管内皮细胞基底膜断裂、线粒体肿胀、内质网损伤严重脱颗粒。（4）EB组兔伤后1、2、4、8小时AST、LDH、HBDH、CK、CK-MB水平均显著高于伤前15分钟（P值均<0.01）。AST水平于伤后2小时达峰值（164±39）U/L。LDH和HBDH水平于伤后4小时达峰值，分别为（1016±246）U/L和（487±54）U/L。CK水平于伤后8小时达峰值（7799±738）U/L。CK-MB水平于伤后2小时达峰值（1848±65）U/L。
高压电烧伤可致兔心脏微血管损伤，改变微循环血流，治疗中应予以充分重视。
