Spillert C R, Vernese N A, Suval W D, Lazaro E J
Am Surg. 1984 Dec;50(12):660-2.
There is a higher mortality in elderly subjects with burns. Whether the same amount of heat will cause a greater degree of thermal injury in elderly subjects and thus account, in part at least, for this increased mortality has not been determined and was, therefore, the purpose of this study. Swiss white mice, 1-year-old (elderly) and 3-months-old (young) were anesthetized with pentobarbital sodium and burned uniformly on a depilated area of the back with a steel disc at 100 F for 10 seconds (10% body burn). Burn severity was evaluated in a blinded manner by gross and microscopic criteria at 1, 2, and 4 days postburn. The mean burn severity 1 day postburn was significantly less in the elderly mice compared with the young mice (1.72 versus 3.22, (P less than 0.001). On the 2nd and 4th days postburn, no differences were noted in the degree of burn severity between the two groups. The early apparent diminished burn severity in the elderly mice was unexpected. Possible mechanisms to account for this difference in the old animals may relate to decreased cutaneous microcirculation, alteration in chemical composition of the skin, and the effects of thromboxane A2 and prostaglandin I2. The clinical relevance of these findings concerns the need for more careful clinical management with intentional overassessment of the initial degree of the thermal damage.
老年烧伤患者的死亡率较高。相同程度的热是否会在老年患者中导致更严重的热损伤，从而至少在一定程度上解释这种死亡率的增加，目前尚未确定，因此这也是本研究的目的。选用1岁（老年）和3个月大（年轻）的瑞士小白鼠，用戊巴比妥钠麻醉后，在背部脱毛区域用直径100华氏度的钢盘均匀烫伤10秒（占体表面积的10%）。在烫伤后1天、2天和4天，采用盲法通过大体和显微镜标准评估烧伤严重程度。烫伤后1天，老年小鼠的平均烧伤严重程度明显低于年轻小鼠（1.72对3.22，P<0.001）。在烫伤后第2天和第4天，两组之间的烧伤严重程度没有差异。老年小鼠早期明显减轻的烧伤严重程度出乎意料。老年动物出现这种差异的可能机制可能与皮肤微循环减少、皮肤化学成分改变以及血栓素A2和前列腺素I2的作用有关。这些发现的临床意义在于需要更谨慎的临床管理，并有意过度评估热损伤的初始程度。
