摘要
目的 了解高压电烧伤对兔心脏微循环的影响。方法将120只清洁级新西兰兔按随机数字表法分为对照组和电伤组，每组60只。电伤组兔用调压器及实验变压器制成高压电烧伤模型（左前肢近心端外侧为电流入口，右后肢近心端外侧为电流出口），对照组接相同装置但不通电致似伤。于伤前15min及伤后5min、1h、2h、4h、8h（各组每时相点10只兔）,兔开胸用激光多普勒组织灌流图像仪检测心尖表面做循环灌流量；每时相点取2只兔左心室壁心肌组织，于光学显微镜和透射电镜下进行微血管形态学观察；耳缘静脉抽血，用全自动生化分析仪榆测AST、乳酸脱氯蜥（LDH）、羟丁酸脱氧酶（HBDH）、肌酸激酶（CK）、心肌型肌酸激酶同工酶（CK-MB）含量。对数据行两因素析因设计的方法分析和LSD检验。结果电伤组兔总体检测结果与对照组比较差异有统计学意义，处理因素主效应F值为425．991-3046．834，P值均小于0．01．统计学结果仅允许在电伤组内进行比较、（1）电伤组兔伤后5min，心尖表面微循环灌流量为（1．96±0．09）V，低于伤前15min的（4．34±0．35）V，P〈0．01；伤后1h灌流艟为（3．43±0．30）V，较伤后5min有所回升，之后呈下降趋势、（2）光学显微镜下可见电伤纰兔伤后8h心肌微静脉及毛细血管出血，有微血栓形成；透射电镜下见电伤组伤后8h毛细血管内皮细胞基膜断裂、线粒体肿胀、创面内质网严重脱颗粒。（3）电伤组伤后1-8h血清AST、LDH、HBDH、CK、CK-MB含量均高于伤前15min（P值均小于0．01），AST以伤后2h最高，为（164±39）U／L；LDH和HBDH以伤后4h最高，分别为（1016±246）U／L、（487±54）U／L；CK以伤后8h最高，为（7799±738）U／L；CK-MB则以伤后1h最高，为（1848±65）U／L。结论高压电烧伤可直接损伤兔心脏微血管并改变微循环血流量，救治时应予以重视。
[Abstract] Objective To study the influence ofhigh-vohage electric burn on tile mierocirculation of heart in rabbit. Methods One-hundred and twenty New Zealand rabbils of clean grade were divided into eontrot group （C） and electric burn group （EB） according to the random number table, wflh 60 rabbits in each group. Rabbits in EB group were subjecteded to high-voltage electric burn （ the electrical current flow into the left foreleg at the lateral side of proximal end and out from the correspondingsite of the right hind leg） with voltage regulator and experimerttal transformer. Rabbits in C group were sham injured with the same devices without electrification. At 15 minutes before injury, and 5 minutes, 1, 2, 4, 8 hour （s） post injury（ PIM or Pltt ） , ten rabbits in each group were chosen to examine the cardiae apex mierocirculation hemoper- fusion （CAMH） wilh laser l）oppler hemoperfusion image instrument. The morphologic changes of mieroves- sels of left ventricular wall tissues of 2 rabbits from each of the 10 rabbits collected at above-mentioned time points were observed with light microscope and lransmission electron microscope. Auricular vein blood of rabbit was harvested at above-mentioned time points for the determination of asparlate amino transferase （AST）, lactate dehydrogenase （LDH）, hydroxybutyrate dehydrogenase （HBDH） , creatine kinase （CK）,and creatine kinase isozyme M B （CK-MB） by full-automatic biochemical analyzer. Data were processed whh two-faetnr analysis of variance and LSD lest. Results （ 1 ） The differences hetween C group and EB group in detection results were statistically signifieant, with F values from 425. 991 tn 3046. 834, P values all below 0.01. Only the data within EB group were eomparable. （2） At PIM 5, the CAMH value of rabbits in EB group was （1.96±0.09） V, which was lower than that at 15 minutes before injury [（4.34 ±0.35） V,P 〈0.01]. The CAMH value of rabbits in EB group was increased at PIH 1 [（3.43±0.30） V], and then it showed a tendency of decrease. （3） Bleeding and microthrombus formation were observed in venule and capillary vessel of rabbits in EB group at PIH 8. Breakage of basement membrane of capillary endothelial cells, mitochondrial swelling, and severe degranulation from damaged endoplasmic reticulum were observed in rabbits of EB group at PIH 8. （4） Levels of AST, LDH, HBDH, CK, and CK-MB in rabbits of EB group were significantly higher at PIH 1, 2, 4, 8 than at 15 minutes before injury （ with P values all below 0.01 ）. The AST level peaked at PIH 2 [ （164± 39） U/L]. Levels of LDH and HBDH peaked at PIH 4, which were respectively （1016±246） U/L and （487±54） U/L. The CK level peaked at PIH 8 [（7799 ± 738） U/L]. The CK-MB level peaked at PIH 2 [ （ 1848 ± 65） U/L]. Conclusions High-voltage elec- tric burn can bring damage to the microvessels of heart in rabbits and change blood flow of microcirculation, which should be given adequate attention during the treatment.
出处
《中华烧伤杂志》
CAS
CSCD
北大核心
2012年第3期173-177,共5页
Chinese Journal of Burns
基金
河北省自然科学基金（302551）
关键词
烧伤
电
心脏
微循环
Burns, electric
Heart
Microcirculation
