爆炸伤大鼠全身炎症反应的研究

A. V. Shulepov, M. I. Shperling, Yu. V. Yurkevich, N. V. Shperling, L. V. Minaeva
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摘要

的目标。评价爆炸伤后循环细胞因子与全身炎症反应的时间变化。材料和方法。实验以60只雄性Wistar大鼠为实验对象,其中大腿软组织损伤大鼠50只,完整大鼠10只。在全身麻醉下,用填充了烟火混合物的碎鞭炮模拟爆炸损伤。在伤后3、7、14和28天,我们对创面及其引流进行大体检查,测量创面面积,评估局部水肿严重程度,并评估血清钾、肌红蛋白TNF-α、IL-1β、IL-6和il -10。伤后3 ~ 7天,可见大量浆液、化脓性渗出,局部水肿明显,创面无明显变化。血清肌红蛋白和钾分别升高2.2 ~ 2.6倍和1.3倍(p < 0.05);此外,我们记录了一种主要的促炎细胞因子IL-1β的升高。伤后14d,创面面积减少24% (p < 0.05),创面引流减少,局部水肿减少。虽然血清肌红蛋白和促炎细胞因子(特别是il -6)水平降低,但与未损伤大鼠相比仍显著升高。伤后28天,纤维化完成,上皮化发生,创面仅留下小痂。然而,血清IL-1β仍比正常动物高1.3倍(p < 0.05),尽管IL-6和TNF-α恢复到参考值。抗炎细胞因子IL-10的浓度在损伤后第14天达到最高值(3.9倍,p < 0.05),瘢痕形成期间IL-10浓度有明显下降(但未达到参考值)。在大鼠的所有再生阶段,爆炸损伤都伴随着促炎和抗炎细胞因子之间的失调平衡。
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Systemic inflammatory response in rats with explosive wound
Aim. To evaluate the temporal changes in circulating cytokines rallying systemic inflammatory response after a blast injury.Material and Methods. Experiments were performed on 60 male Wistar rats (50 rats with blast-related soft tissue injury of the thigh and 10 intact rats). Blast injury was modeled under general anaesthesia using grater firecrackers stuffed with a pyrotechnic mixture. After 3, 7, 14 and 28 days post injury, we carried out a gross examination of the wound and its drainage, measured wound area, assessed local oedema severity, and evaluated serum potassium, myoglobin TNF-α, IL-1β, IL-6, and IL-10.Results. Three to seven days post injury, therewas abundant serous and purulent exudate and pronounced local edema without considerable changes in the wound area. Serum myoglobin and potassium were raised 2.2-2.6-fold and 1.3-fold, respectively (p < 0.05); in addition, we documented the elevation of a major pro-inflammatory cytokine IL-1β. Fourteen days post injury, wound area reduced by 24%, (p < 0.05) along with the decreased wound drainage and local edema of the injured area. Although the levels of serum myoglobin and pro-inflammatory cytokines (in particularIL-6) lowered, they were still significantly higher as compared with the intact rats. Twenty eight days post injury, fibrosis has been completed, epithelialization occurred and only a small scab remained on the wound surface. Yet, serum IL-1β still was 1.3-fold higher than in the intact animals (p < 0.05), albeit IL-6 and TNF-α returned to the reference values. The concentration of anti-inflammatory cytokine IL-10 reached its maximum values relative to the control (3.9-fold, p < 0.05) to the 14th day post injury that was followed by a considerable reduction (though not reaching the reference values) by the period of scar formation.Conclusion. Blast injury in rats is accompanied by a dysregulated balance between pro-inflammatory and anti-inflammatory cytokines throughout all regeneration phases.
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