2019 年第 7 期 第 14 卷

重组人生长激素早期应用对严重烧伤大鼠肠源性脓毒症和器官损害及预后的影响

Effect of early application of recombinant human growth hormone on gut-derived sepsis, organ damage and prognosis in severely burned rats

作者：蒙俊黄洁吕钦王思雨杨堃

英文作者：

单位：650032昆明医科大学第一附属医院心血管外科(蒙俊)，麻醉科(黄洁、吕钦、王思雨、杨堃)

英文单位：

关键词：严重烧伤；大鼠模型；重组人生长激素；肠源性脓毒症；器官损害

英文关键词：

• 摘要：

• 【摘要】目的    分析重组人生长激素(rhGH)早期应用对严重烧伤大鼠肠源性脓毒症、器官损害及预后的影响。方法    选择成年雄性无特定病原体级Wistar大鼠30只，完全随机分为对照组、烧伤组、烧伤+rhGH组，各10只。烧伤组、烧伤+rhGH组大鼠行烧伤造模，对照组大鼠正常饲养。烧伤+rhGH组大鼠烧伤2 h后，每天定时给予皮下注射rhGH，连续注射3 d，烧伤组大鼠造模后给予常规处理，烧伤后2 h注射等量0.9%氯化钠注射液，连续注射3 d。观察烧伤组和烧伤+rhGH组大鼠造模10 d后脏器脓肿发生情况、细菌检出情况和病理组织学变化，比较3组大鼠造模10 d后呼吸频率、体质量、存活情况，血清内毒素、肿瘤坏死因子α（TNF-α）、丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、尿素氮、肌酐水平。结果    烧伤组大鼠造模10 d后脏器脓肿检出率和细菌检出率均明显高于烧伤+rhGH组［67.5%(27/40)比37.5%(15/40)、88.6%（62/70）比45.7%（32/70）］，差异均有统计学意义（均P＜0.05）。造模10 d后，烧伤+rhGH组呼吸频率低于烧伤组，体质量和存活率高于烧伤组，差异均有统计学意义（均P＜0.05）。造模10 d后，烧伤+rhGH组大鼠各脏器病理情况均接近正常，且明显优于烧伤组。造模10 d后烧伤组血清内毒素、TNF-α、ALT、AST、尿素氮、肌酐水平均高于对照组和烧伤+rhGH组，差异均有统计学意义（均P＜0.05）。结论    对于严重烧伤大鼠模型，重组人生长激素早期应用能够减少肠源性脓毒症发生，减轻器官损伤，并改善预后。

• 【Abstract】Objective    To analyze the effect of early application of recombinant human growth hormone(rhGH) on gut-derived sepsis, organ damage and prognosis in severely burned rats. Methods    Thirty adult male Wistar rats were randomly divided into blank group, burn group and burn+rhGH group, with 10 rats in each group. Rats in burn group and burn+rhGH group were made burn model. Rats in blank group were fed normally. Rats in burn+rhGH group were given subcutaneous injection of rhGH at regular intervals of 2 hours after burn for 3 days. Rats in burn group were given normal modeling and routine treatment, 2 hours after burn, 0.9% sodium chloride injection was injected for 3 days. Occurrence of organ abscess, bacterial detection and histopathological changes were observed in burn group and burn+rhGH group 10 days after modeling. Respiratory rate, body mass, survival, serum endotoxin, tumor necrosis factor-α(TNF-α), alanine aminotransferase(ALT), aspartate aminotransferase(AST), urea nitrogen and creatinine levels were analyzed in 3 groups 10 days after modeling. Results    Incidence of organ abscess and detection rate of bacteria in burn group were significantly higher than those in burn+rhGH group［67.5%(27/40) vs 37.5%(15/40), 88.6%（62/70） vs 45.7%(32/70)］(both P＜0.05). Respiratory rate was significantly lower and body mass and survival rate were significantly higher in burn+rhGH group than those in burn group(all P＜0.05). Ten days after modeling, pathological manifestation of organs in burn+rhGH group was similar to that in blank group and significantly better than that in burn group. Serum levels of endotoxin, TNF-α, ALT, AST, ururea nitrogen and creatinine in burn group were significantly higher than those in control group and burn+rhGH group（all P＜0.05）. Conclusion    Early application of recombinant human growth hormone can reduce the incidence of gut-derived sepsis, alleviate organ damage and improve the prognosis in severely burned rats.