Zhang Xuemin, Chen Jiong, Zhou Jianjun, Xing Nan, Shi Xiaoli
Burns and Skin Repair Surgery, Third Affiliated Hospital, Whenzhou Medical University, Ruian 325200, China.
Burns and Skin Repair Surgery, Third Affiliated Hospital, Whenzhou Medical University, Ruian 325200, China. Email:
Zhonghua Yi Xue Za Zhi. 2014 Jul 1;94(25):1979-83.
To explore the effects on ischemia-reperfusion injury with different regimens of fluid resuscitation during severe burn shock stage in swines.
A total of 24 Guangxi BA-MA mini-swine were numbered from 1 to 24 and randomly divided by EXCEL 2007 into 4 groups of succinylated gelatin, hydroxyethyl starch (HES 130/0.4), Parkland and allogeneic plasma (n = 6 each). Then the burn shock model was established. And fluid resuscitation therapy was applied according to the established regimens of burn shock fluid resuscitation. Blood samples were collected from the animals prior to burn injury and again at intervals of 4, 8, 24 and 48 hours post-injury. The levels of malondialdehyde, superoxide dismutase (SOD), xanthine oxidase (XOD) and total antioxidant capacity (T-AOC) were measured. And the results were analyzed statistically.
Six swines within each group survived the shock stage and the outliers in detection index were eliminated. Then there were 5 swines in each group. The MDA of allogeneic plasma group at intervals of 8 hours was significantly lower than that of succinylated gelatin group, but higher than that of Parkland group [(3.46 ± 0.40) vs (4.55 ± 0.82), (2.59 ± 0.35) µmol/L, both P < 0.05]. The level of SOD had statistical difference at 48 hours between the HES 130/0.4 and allogeneic plasma groups ((72.55 ± 5.70) vs (65.42 ± 5.07) U/ml, P < 0.05). The level of XOD of the succinylated gelatin group at 4, 8 hour and they increased when compared to pre-burn ((12.00 ± 0.57), (11.28 ± 0.71) vs (9.12 ± 0.51) U/L, both P < 0.01).Statistical significance was observed at 4, 8 hours between succinylated gelatin and allogeneic plasma groups ((10.39 ± 1.24), (9.59 ± 1.17) U/L, both P < 0.01). The T-AOC of HES 130/0.4 group at 8 hours exceed the pre-burn ((2.06 ± 0.43) vs (1.30 ± 0.35) U/ml, P < 0.05). The allogeneic plasma group at 4, 8 hours showed increase when compared to pre-burn ((1.55 ± 0.37), (2.59 ± 0.60) vs (1.06 ± 0.13) U/ml, both P < 0.05). The succinylated gelatin group at 8, 48 hours decreased during the corresponding phase of allogeneic plasma group ((1.14 ± 0.26), (0.89 ± 0.20) vs (2.59 ± 0.60), (1.16 ± 0.20) U/ml, both P < 0.05). The comparison at 24, 48 hours between HES 130/0.4 and allogeneic plasma groups ((1.84 ± 0.41), (1.53 ± 0.21) vs (1.13 ± 0.35), (1.16 ± 0.20) U/ml) had statistical difference (both P < 0.01). The Parkland group at intervals of 8 hours was lower than that of allogeneic plasma group ((1.31 ± 0.19) vs (2.59 ± 0.60) U/ml, P < 0.01).
HES130/0.4 and allogeneic plasma have comparable the parallel minimum damage effect on ischemia-reperfusion injury during burn shock stage are.
探讨不同液体复苏方案对猪严重烧伤休克期缺血再灌注损伤的影响。
将24头广西巴马小型猪编号为1至24，用EXCEL 2007随机分为琥珀酰明胶组、羟乙基淀粉（HES 130/0.4）组、Parkland组和异体血浆组（每组6头）。然后建立烧伤休克模型，并按照既定的烧伤休克液体复苏方案进行液体复苏治疗。在烧伤前及伤后4、8、24和48小时从动物采集血样，检测丙二醛、超氧化物歧化酶（SOD）、黄嘌呤氧化酶（XOD）和总抗氧化能力（T-AOC）水平，并对结果进行统计学分析。
每组6头猪度过休克期，剔除检测指标异常值后，每组剩余5头猪。异体血浆组伤后8小时的丙二醛水平显著低于琥珀酰明胶组，但高于Parkland组[（3.46±0.40）对（4.55±0.82），（2.59±0.35）μmol/L，P均<0.05]。HES 130/0.4组和异体血浆组在伤后48小时的SOD水平有统计学差异[（72.55±5.70）对（65.42±5.07）U/ml，P<0.05]。琥珀酰明胶组伤后4、8小时的XOD水平较烧伤前升高[（12.00±0.57），（11.28±0.71）对（9.12±0.51）U/L，P均<0.01]，琥珀酰明胶组和异体血浆组在伤后4、8小时有统计学差异[（10.39±1.24），（9.59±1.17）U/L，P均<0.01]。HES 130/0.4组伤后8小时的T-AOC超过烧伤前水平[（2.06±0.43）对（1.30±0.35）U/ml，P<0.05]。异体血浆组伤后4、8小时较烧伤前升高[（1.55±0.37），（2.59±0.60）对（1.06±0.13）U/ml，P均<0.05]。琥珀酰明胶组在伤后8、48小时低于异体血浆组相应时段水平[（1.14±0.26），（0.89±0.20）对（2.59±0.60），（1.16±0.20）U/ml，P均<0.05]。HES 130/0.4组和异体血浆组在伤后24、48小时比较[（1.84±0.41），（1.53±0.21）对（1.13±0.35），（1.16±0.20）U/ml]有统计学差异（P均<0.01）。Parkland组伤后8小时低于异体血浆组[（1.31±0.19）对（2.59±0.60）U/ml，P<0.01]。
HES130/0.4和异体血浆对烧伤休克期缺血再灌注损伤具有相当的、平行的最小损伤作用。
