Zhou J P, Gao Z, Sun Y X, Chen X L, Wu X S, Wang F
Department of Burns, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
Zhonghua Shao Shang Za Zhi. 2017 Jan 20;33(1):31-36. doi: 10.3760/cma.j.issn.1009-2587.2017.01.008.
To explore the effects of hypertonic sodium saline (HSS) resuscitation on the liver damage of rats at early stage of severe scald. Fifty-six SD rats were divided into sham injury group (SI, =8), lactated Ringer's solution group (LRS, =24), and group HSS (=24) according to the random number table. Rats in group SI were sham injured without resuscitation, while rats in the other two groups were reproduced deep partial-thickness to full-thickness scald model with 30% total body surface area on the back. Rats in group LRS were resuscitated with LRS, while rats in group HSS were resuscitated with 300 mmol/L sodium ion solution according to the Parkland formula. Blood of abdominal aorta and liver of 8 rats in group SI immediately post injury and in the other two groups at post injury hour (PIH) 2, 8, and 24 respectively were collected. Then liver water content was determined by dry-wet weight method. Serum content of alanine aminotransferase (ALT) and aspartate transaminase (AST) was detected by automatic biochemical analyzer. Serum content of tumor necrosis factor α (TNF-α), interleukin-1 (IL-1), and high mobility group box 1 (HMGB1) was determined by enzyme-linked immunosorbent assay. Liver content of malondialdehyde (MDA) and superoxide dismutase (SOD) was detected by ultraviolet spectrophotometer. Pathologic changes of liver were observed by HE staining. Data were processed with one-way analysis of variance and SNK test. (1) At PIH 2, 8, and 24, liver water content of rats in group LRS was higher than that in group SI and group HSS (<0.05 or <0.01). (2) At PIH 2, serum ALT content of rats in the three groups was similar (with values above 0.05). At PIH 8 and 24, serum ALT content of rats in group HSS and group LRS was higher than that in group SI (<0.05 or <0.01), and serum ALT content of rats in group HSS was lower than that in group LRS (with values below 0.01). At PIH 2, 8, and 24, serum AST content of rats in group HSS and group LRS was higher than that in group SI (with values below 0.01). At PIH 2 and 8, serum AST content of rats in group HSS was lower than that in group LRS (<0.05 or <0.01). (3) At PIH 2 and 8, serum TNF-α content of rats in group LRS was (123±39) and (153±38) pg/mL respectively, higher than that in group SI [(60±18) pg/mL] and group HSS [(85±10) and (94±16) pg/mL respectively, with values below 0.01]. At PIH 8, serum TNF-α content of rats in group HSS was higher than that in group SI (<0.05). At PIH 24, serum TNF-α content of rats in the three groups was similar (with values above 0.05). At PIH 2, 8, and 24, serum IL-1 content of rats in group LRS was (122±35), (141±30), and (122±31) pg/mL respectively, and that in group HSS was (80±12), (93±15), and (80±11) pg/mL respectively, all higher than that in group SI [(40±17) pg/mL, with values below 0.01]; serum IL-1 content of rats in group HSS was lower than that in group LRS (with values below 0.01). At PIH 2, serum HMGB1 content of rats in the three groups was similar (with values above 0.05). At PIH 8 and 24, serum HMGB1 content of rats in group LRS was (0.386±0.146) and (0.590±0.188) ng/mL respectively, higher than that in group SI [(0.050±0.027) ng/mL] and group HSS [(0.143±0.038) and (0.309±0.095) ng/mL respectively, with values below 0.01]. At PIH 24, serum HMGB1 content of rats in group HSS was higher than that in group SI (<0.01). (4) At PIH 2, 8, and 24, liver MDA content of rats in group HSS and group LRS was higher than that in group SI and their liver SOD content was lower than that in group SI (with values below 0.01); liver MDA content of rats in group HSS was lower than that in group LRS and their liver SOD content was higher than that in group LRS (with values below 0.01). (5) Compared with those of rats in group SI, liver cells of rats in group LRS showed massive steatosis at each time point, and liver cell-edema appeared at PIH 8 and 24; while liver cells of rats in group HSS showed little steatosis only at PIH 8 and 24, and the liver cell-edema never appeared. Compared with LRS, HSS resuscitation can alleviate liver injury of rats at the early stage of severe scald through relieving inflammatory mediators and reducing degree of oxidative stress, etc.
探讨高渗盐水(HSS)复苏对严重烫伤大鼠早期肝损伤的影响。将56只SD大鼠按随机数字表法分为假伤组(SI,n = 8)、乳酸林格液组(LRS,n = 24)和HSS组(n = 24)。SI组大鼠仅行假伤,不行复苏;其他两组大鼠均采用背部30%体表面积深Ⅱ度至Ⅲ度烫伤模型。LRS组大鼠采用乳酸林格液复苏,HSS组大鼠按Parkland公式采用300 mmol/L钠离子溶液复苏。分别于伤后即刻(SI组8只大鼠)及伤后2、8、24 h(LRS组和HSS组各8只大鼠)采集腹主动脉血及肝脏组织,采用干湿重法测定肝脏含水量,全自动生化分析仪检测血清丙氨酸氨基转移酶(ALT)和天冬氨酸氨基转移酶(AST)含量,酶联免疫吸附法测定血清肿瘤坏死因子α(TNF-α)、白细胞介素-1(IL-1)和高迁移率族蛋白B1(HMGB1)含量,紫外分光光度计检测肝脏丙二醛(MDA)和超氧化物歧化酶(SOD)含量,HE染色观察肝脏病理变化。数据采用单因素方差分析及SNK检验。(1)伤后2、8、24 h,LRS组大鼠肝脏含水量高于SI组和HSS组(P<0.05或P<0.01)。(2)伤后2 h,三组大鼠血清ALT含量相近(P>0.05)。伤后8、24 h,HSS组和LRS组大鼠血清ALT含量高于SI组(P<0.05或P<0.01),且HSS组低于LRS组(P<0.01)。伤后2、8、24 h,HSS组和LRS组大鼠血清AST含量高于SI组(P<0.01)。伤后2、8 h,HSS组大鼠血清AST含量低于LRS组(P<0.05或P<0.01)。(3)伤后2、8 h,LRS组大鼠血清TNF-α含量分别为(123±39)、(153±38)pg/mL,高于SI组[(60±18)pg/mL]和HSS组[分别为(85±10)、(94±16)pg/mL,P<0.01]。伤后8 h,HSS组大鼠血清TNF-α含量高于SI组(P<0.05)。伤后24 h,三组大鼠血清TNF-α含量相近(P>0.05)。伤后2、8、24 h,LRS组大鼠血清IL-1含量分别为(122±35)、(141±30)、(122±31)pg/mL,HSS组分别为(80±12)、(93±15)、(80±?11)pg/mL,均高于SI组[(40±17)pg/mL,P<0.01];HSS组大鼠血清IL-1含量低于LRS组(P<0.01)。伤后2 h,三组大鼠血清HMGB1含量相近(P>0.05)。伤后8、24 h,LRS组大鼠血清HMGB1含量分别为(0.386±0.146)、(0.590±0.188)ng/mL,高于SI组[(0.050±0.027)ng/mL]和HSS组[分别为(0.143±0.038)、(0.309±0.095)ng/mL,P<0.01]。伤后24 h,HSS组大鼠血清HMGB1含量高于SI组(P<0.01)。(4)伤后2、8、24 h,HSS组和LRS组大鼠肝脏MDA含量高于SI组,SOD含量低于SI组(P<0.01);HSS组大鼠肝脏MDA含量低于LRS组,SOD含量高于LRS组(P<0.01)。(5)与SI组大鼠相比,LRS组大鼠各时间点肝细胞均出现大量脂肪变性,伤后8、24 h出现肝细胞水肿;而HSS组大鼠仅在伤后8、24 h出现少量脂肪变性,未出现肝细胞水肿。与LRS组相比,HSS复苏可通过减轻炎症介质释放、降低氧化应激程度等减轻严重烫伤大鼠早期肝损伤。