發(fā)布時間：2018-11-18 07:36

【摘要】：目的:高壓電燒傷除即刻性電熱損傷外,還存在著原因未明的漸進(jìn)性損傷。研究表明,微循環(huán)障礙在電燒傷后的漸進(jìn)性損傷發(fā)生和發(fā)展過程中起關(guān)鍵作用,并發(fā)現(xiàn)電傷后的微循環(huán)障礙主要由微血管損傷及微血流障礙所致。在影響微循環(huán)血流動力學(xué)和流變學(xué)指標(biāo)中,血小板流變行為異常起重要作用。血小板是血液的主要成分之一,是影響微循環(huán)血流動力學(xué)及流變學(xué)的重要因素。高壓電燒傷通過激發(fā)血小板活化,使血小板聚集性增加、黏附性增強(qiáng)、促釋放反應(yīng),從而加重微循環(huán)障礙。但血小板流變行為異常的分子機(jī)制目前尚不清楚。本研究通過檢測大鼠高壓電燒傷后早期血清β-血小板球蛋白(β-TG)及血小板因子4(PF-4)含量,并采用烏司他丁(UTI)進(jìn)行干預(yù),旨在進(jìn)一步探索高壓電燒傷后血小板流變行為異常的相關(guān)機(jī)制和防治方法。方法:1分組健康成年雄性SD大鼠240只,隨機(jī)分為假高壓電燒傷組(假傷組)、高壓電燒傷組(電傷組)、高壓電燒傷復(fù)合鹽水治療組(鹽水組)、高壓電燒傷復(fù)合UTI治療組(UTI組),每組各60只。每組又按觀察時間分為傷前15min、傷后5min、傷后1h、2h、4h、8h六個時相組,每時相組10只。2模型制作大鼠腹部備皮及消毒。用10%水合氯醛溶液腹腔注射麻醉大鼠(3ml/kg),麻醉成功后,將大鼠仰臥固定于專用電擊實(shí)驗(yàn)臺上,將兩個1cm×1cm電極片分別固定于大鼠的左上肢(電流入口)、右下肢(電流出口)。連接實(shí)驗(yàn)變壓器和調(diào)壓器電線,接通電源,調(diào)節(jié)調(diào)壓器使升壓器輸出電壓至2k V,接通升壓器輸出電源,使高壓電流通過大鼠,電擊3s,模型制作成功。假傷組只連電線不通電致假傷。電傷5min內(nèi),UTI組腹腔注射1%UTI(按2×104u/kg即2ml/kg給藥),鹽水組腹腔內(nèi)注射2ml/kg生理鹽水。3指標(biāo)檢測:對模型大鼠開胸暴露心臟,直視下心臟抽血6ml,置于無菌塑料試管中,靜置30min,待血清析出后上離心機(jī),以3000轉(zhuǎn)/min離心10min,取上清液置于Eppendorf管中在-70℃條件下保存。采用ELISA雙夾心抗體法,分別檢測每組大鼠六個時相組血清β-TG、PF-4含量。4統(tǒng)計(jì)處理:采用SPSS 21.0統(tǒng)計(jì)軟件,行兩因素析因設(shè)計(jì)的方差分析,多重比較采用LSD法t檢驗(yàn)。以P0.05為顯著性檢驗(yàn)水準(zhǔn)。結(jié)果:1大鼠血清β-TG含量變化電傷組血清β-TG含量的平均水平高于假傷組(F=172.186,P0.01);電傷組血清β-TG含量受電傷后時間變量影響(F=32.164,P0.01),在電傷后1h、2h、4h和8h時高于傷前值(P值均小于0.01)。UTI組血清β-TG含量的平均水平低于鹽水組(F=21.295,P0.01);UTI血清β-TG含量受電傷后用藥時間變量影響(F=109.115,P0.01),在電傷后1h和4h時低于鹽水組(P值均小于0.01)。2大鼠血清PF-4含量變化電傷組血清PF-4含量的平均水平高于假傷組(F=29.108,P0.01);電傷組血清PF-4含量受電傷后時間變量影響(F=6.943,P0.01),在電傷后2h和8h時高于傷前值(P值均小于0.01)。UTI組血清PF-4含量的平均水平低于鹽水組(F=37.874,P0.01);UTI血清PF-4含量受電傷后用藥時間變量影響(F=15.026,P0.01),在電傷后1h、2h、4h、8h時低于鹽水組(P值均小于0.01)。結(jié)論:高壓電燒傷可促進(jìn)大鼠血小板釋放反應(yīng),引起大鼠高壓電燒傷早期血清β-TG和PF-4含量升高。UTI則抑制大鼠血小板釋放反應(yīng),使大鼠高壓電燒傷后血漿β-TG和PF-4含量降低,從而改善血小板流變行為。
[Abstract]:Objective: In addition to the immediate heating injury of high-voltage electric burn, there is an unknown progressive injury. The study showed that the microcirculatory disturbance played a key role in the occurrence and development of progressive injury after electric burn, and found that the microcirculatory disturbance after electric burn was mainly caused by microvessel injury and micro-blood flow. The changes of platelet rheological behavior play an important role in the hemodynamic and rheology of the microcirculation. The platelet is one of the main components of the blood, which is an important factor that affects the hemodynamics and the rheology of the microcirculation. The high-voltage electric burn can stimulate the activation of the platelet, increase the aggregation of the platelet, enhance the adhesion and release the reaction, thereby increasing the microcirculation disturbance. But the molecular mechanism of the abnormal platelet-rheological behavior is not yet clear. In this study, the content of platelet factor 4 (PF-4) and the content of platelet factor 4 (PF-4) were measured in the early stage of high-voltage burn in rats, and the intervention of Ulinastatin (UTI) was used to further explore the related mechanisms and methods to prevent the abnormal changes of platelet rheological behavior after high-voltage burn. Methods: 240 healthy adult male SD rats were randomly divided into pseudo-high-voltage burn group (sham-wound group), high-voltage electric burn group (electric injury group), high-voltage burn composite saline treatment group (saline group), high-voltage burn composite UTI treatment group (UTI group), each group of 60 rats. In each group, the observation time was divided into 15 minutes before the injury, 5 minutes after the injury, 1 h, 2 h, 4 h and 8 h after the injury. Anesthetized rats (3ml/ kg) were injected intraperitoneally with 10% water-chloral solution, and after the anesthesia was successful, the rats were fixed on a special electric shock test bench, and the two 1cm-1cm electrode pieces were fixed to the left upper limb (current inlet) and the right lower limb (current outlet) of the rat respectively. Connect the test transformer and voltage regulator wire, turn on the power supply, adjust the voltage regulator to make the booster output voltage to 2k V, turn on the booster output power supply, and make the high-voltage current pass through the rat and the electric shock 3s, and the model is made to be successful. The false-wound group is not only connected with a wire to cause a false injury. In 5 minutes of electroinjury, 1% of UTI (2/ 104u/ kg, i.e. 2ml/ kg) was injected into the abdominal cavity of the UTI group, and 2ml/ kg of normal saline was injected intraperitoneally in the saline group. The solution was centrifuged at 3000 rpm for 10 min, and the supernatant was placed in the Eppendorf tube at-70.degree. C. for 10 min. The serum levels of triglyceride, PF-4 and the content of PF-4 in six groups of rats in each group were respectively detected by ELISA and double-sandwich antibody method. The results of statistical analysis were as follows: SPSS 2.0 statistical software and two-factor analysis of variance of the design were performed, and the multiple comparisons were tested by means of LSD. The level of the test was significantly higher than that of P 0.05. Results: The level of serum triglyceride-TG in the serum of the rats was higher than that of the sham-wound group (F = 172.186, P 0.01), and the serum level of TG-TG in the electroinjury group was affected by the time-dependent variable after electroinjury (F = 32.164, P0.01). At 4h and 8h, the pre-injury value (P-value was less than 0.01). The level of serum triglyceride-TG in the UTI group was lower than that of the saline group (F = 21.295, P0.01); the content of the serum triglyceride-TG in the UTI group was affected by the time-dependent variable after electroinjury (F = 109.115, P0.01). The mean level of PF-4 in the serum of the rats was higher than that of the sham-wound group (F = 29. 108, P 0.01), and the serum PF-4 content in the electroinjury group was affected by the time-dependent variable after electroinjury (F = 6.943, P0.01). The pre-injury value (P-value was less than 0.01) at 2h and 8h after electroinjury. The mean level of PF-4 in the UTI group was lower than that of the saline group (F = 37. 874, P0.01); the content of PF-4 in the UTI group was affected by the time-dependent variable after electroinjury (F = 15.026, P0.01), and was lower than that of the saline group at 1h, 2h, 4h, and 8h after electric injury (P <0.01). Conclusion: High-voltage burn can promote the release of platelet in rats, and raise the level of serum level-TG and PF-4 in the early stage of high-voltage burn in rats. UTI inhibited platelet-release in rats, and decreased the content of plasma-TG and PF-4 after high-voltage burn in rats, thus improving the rheological behavior of platelets.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R647

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