Tang F-B, Dai Y-L, Hu S, Ma L-Q, Li J-Y, Zhang H-P, Zhang W-H, Li Y-G, Wang H-B, Lin H-Y, Hu Q, Li L
Chinese PLA General Hospital, Beijing, China.
Chinese People's Armed Police Forces Academy, Hebei, China.
Eur J Trauma Emerg Surg. 2017 Dec;43(6):875-882. doi: 10.1007/s00068-016-0748-4. Epub 2017 Jan 9.
High vasopermeability and excessive inflammation following severe burns may result in tissue edema, organ dysfunction and the loss of circulatory plasma volume, which can influence the doctor to do the prognosis to the patients. The study aims to examine whether Xuebijing injection (XBJ), an extracts of a traditional Chinese medicine used to treat sepsis in clinic, can reduces fluid requirements by inhibiting vasopermeability and tissue edema in a canine model after burn injury.
Twenty-four beagle dogs were subjected to 50% TBSA burns, and then were randomly allocated to the following three groups: lactated Ringer's resuscitation (LR) group (n = 8), immediate LR containing Xuebijing injection (LR/XBJ) group (n = 8), and operation control group (n = 8). Hemodynamic variables and net fluid accumulation were measured. Blood samples were collected for measurement of hematocrit and circulatory plasma volume (PV). At 24 h after burn injury, heart, lung, small intestine and kidney were harvested for evaluation of the activities of myeloperoxidase (MPO) and neutrophil elastase (NE), vasopermeability, tissue water content and the amount of neutrophil infiltration.
XBJ treatment significantly reduced net fluid accumulation, and pulmonary vascular permeability index (PVPI), extravascular lung water index (ELWI), and water content of heart, small intestine, kidney and lung compared with LR group. Furthermore, XBJ infusion significantly reduced tissue activities of MPO and NE compared with LR group. The amount of neutrophil infiltration in LR/XBJ group was lower than that in LR group.
These results indicate that XBJ injection can reduce fluid requirements by inhibition of neutrophil protease-induced high vasopermeability and tissue edema.
严重烧伤后高血管通透性和过度炎症反应可导致组织水肿、器官功能障碍及循环血浆量丢失，这会影响医生对患者的预后判断。本研究旨在探讨临床用于治疗脓毒症的中药提取物血必净注射液（XBJ）是否能通过抑制烧伤犬模型的血管通透性和组织水肿来减少液体需求量。
24只比格犬接受50%体表面积烧伤，然后随机分为以下三组：乳酸林格液复苏（LR）组（n = 8）、即刻给予含血必净注射液的乳酸林格液（LR/XBJ）组（n = 8）和手术对照组（n = 8）。测量血流动力学变量和净液体蓄积量。采集血样测定血细胞比容和循环血浆量（PV）。烧伤后24小时，取心脏、肺、小肠和肾脏，评估髓过氧化物酶（MPO）和中性粒细胞弹性蛋白酶（NE）的活性、血管通透性、组织含水量及中性粒细胞浸润量。
与LR组相比，XBJ治疗显著减少了净液体蓄积量、肺血管通透性指数（PVPI）、血管外肺水指数（ELWI）以及心脏、小肠、肾脏和肺的含水量。此外，与LR组相比，输注XBJ显著降低了组织中MPO和NE的活性。LR/XBJ组中性粒细胞浸润量低于LR组。
这些结果表明，血必净注射液可通过抑制中性粒细胞蛋白酶诱导的高血管通透性和组织水肿来减少液体需求量。
