张鲜英 刘毅 张世范 张绪生 于晟 蔡黔 张诚 肖斌 张斌 姜疆 田文艳

    【摘要】 目的 探讨高原地区不同海拔高度(3 840 m,1 517 m)大鼠严重烫伤后延迟复苏心肌组织内皮素-1(ET-1)和降钙素基因相关肽(CGRP)的变化特点。方法雄性Wistar大鼠240只随机分为延迟复苏组、即时复苏组和正常对照组，建立总体表面积30%的Ⅲ度烧伤模型，分别于伤后1、6、12、24、72和168 h取材。应用放射免疫法检测心肌组织中ET-1和CGRP的含量。结果 ①延迟复苏组ET-1和CGRP均在伤后6 h开始升高，ET-1在两个海拔高度与正常对照组相比分别增长了2.8倍和3.6倍，CGRP分别增长了2.2倍和1.5倍(P均<0.01)；但延迟复苏组ET-1和CGRP上升趋势明显低于延迟复苏组(P均<0.01)。②延迟复苏组ET-1在1 517 m自伤后6 h开始上升，至24 h达峰值，但在3 840 m于伤后72 h达峰值，增高持续168 h；CGRP在1 517 m自伤后6 h明显上升，12 h达峰值，但在3 840 m高度于伤后72 h达峰值；在3 840 m高度，ET-1/CGRP比值变化明显。结论 高原地区大鼠严重烫伤后随海拔升高，ET-1释放明显增多，但CGRP升高速度缓慢，释放量明显降低，提示海拔越高，心肌保护物质消耗越多，ET-1/CGRP的调节作用变化显著。

    【关键词】 烧伤； 延迟复苏； 心肌； 内皮素-1； 降钙素基因相关肽； 高原

    Changes in endothelin-1 and calcitonin gene-related peptide in myocardium after severe burn and delayed fluid resuscitation in rats at different altitudes on plateau

    ZHANG Xian-ying, LIU Yi, ZHANG Shi-fan, ZHANG Xu-sheng, YU Sheng, CAI Qian, ZHANG Cheng, XIAO Bin, ZHANG Bin, JIANG Jiang, TIAN Wen-yan.

    Department of Burn and Plastic Surgery, Lanzhou General Hospital, Lanzhou Command, PLA, Lanzhou 730050, Gansu, China

    【Abstract】 Objective To explore changes in endothelin-1(ET-1) and calcitonin gene-related peptide (CGRP) in the myocardium after severe burn and delayed fluid resuscitation in rats at different altitudes. Methods Two hundred and forty male Wistar rats were employed as the experimental models with full-thickness burn of 30% total body surface area (TBSA), and they were randomly divided into three groups: delayed fluid resuscitation group (DFR), immediate fluid resuscitation group (IFR) and control group (CG). Samples of myocardial tissue were harvested at 1 hour, 6 hours, 12 hours, 24 hours, 72 hours, 168 hours postburn respectively. The changes in ET-1 and CGRP contents were determined by means of radio immunological assay. Results ①The contents of ET-1 and CGRP in DFR group tended to increase at 6 hours after burn, ET-1 was higher 2.8, 3.6 fold, while CGRP higher by 2.2, 1.5 fold (P<0.01), compared with that of CG respectively at 1 517 m and 3 840 m. The tendency of rise of ET-1 and CGRP was significantly less conspicuous in IFR group than that in DFR group. ②The contents of ET-1 in DFR group tended to increase at 6 hours and reached the peak at 24 hours after burn at 1 517 m, while the levels reached the peak at 72 hours after burn at 3 840 m, and the change lasted for 168 hours in DFR group. The contents of CGRP increased significantly at 6 hours and reached the peak at 12 hours at 1 517 m, while they reached the peak at 72 hours after burn at 3 840 m. Conclusion The myocardial contents of ET-1 tend to increase significantly with the elevation of altitude after severe burn in rats, but the contents of CGRP increased lagged behind. The results show that the higher the altitude is, the more the exhaustion of protective agents of the myocardium, thus resulting in changes in ET-1/CGRP. ......