Harada T, Izaki S, Tsutsumi H, Kobayashi M, Kitamura K
Department of Emergency and Critical Care Medicine, Saitama Medical Centre, Saitama Medical School, Kawagoe, Japan.
Burns. 1998 Aug;24(5):464-9. doi: 10.1016/s0305-4179(98)00034-5.
Progressive burn wound necrosis is an important factor as a cause of delayed healing during clinical therapy of burns. Among the causes of progressive necrosis have been attributed an insufficient blood supply or a dehydration at the zone of stasis just beneath the zone of coagulation. In a previous study evidence was presented that hypernatremia, an osmotic injury, may act to promote progressive tissue or cell death of the superficial dermal wound resulting from a heat injury. To test this hypothesis pathological features of cell death in the second-degree burn wound in the rat with hypernatremia were investigated and evidence for apoptosis in hair follicle cells was observed. Rats in the hypernatremic group were administered 10 ml of hypertonic sodium solution (850 meq 1(-1)) and the control rats were treated with 10 ml of hyponatremic solution (100 meq 1(-1)) to prevent hypernatremia. After 24 h postburn the average incidence of hair follicles (ratio to the normal skin) in the hypernatremic group was 30.1 +/-11.6 per cent and significantly lower when compared with the control group (87.6+/-6.0 per cent). The numbers of hair follicles were studied by haematoxylin and eosin stain, and the apoptotic process was investigated by an immunochemical assay and electron microscopy.
进行性烧伤创面坏死是烧伤临床治疗中导致愈合延迟的一个重要因素。在进行性坏死的原因中，凝血带下方的淤滞区血液供应不足或脱水被认为是其原因。在之前的一项研究中，有证据表明高钠血症这种渗透性损伤可能会促进热损伤导致的浅表真皮伤口的组织或细胞进行性死亡。为了验证这一假设，研究了高钠血症大鼠二度烧伤创面细胞死亡的病理特征，并观察到毛囊细胞凋亡的证据。高钠血症组大鼠给予10 ml高渗钠溶液（850 meq·l⁻¹），对照组大鼠给予10 ml低钠溶液（100 meq·l⁻¹）以预防高钠血症。烧伤后24小时，高钠血症组毛囊的平均发生率（与正常皮肤的比率）为30.1±11.6%，与对照组（87.6±6.0%）相比显著降低。通过苏木精和伊红染色研究毛囊数量，通过免疫化学分析和电子显微镜研究凋亡过程。
