烧伤与脂质过氧化损伤

本文观察了烧伤患者15天内血浆和RBC的脂质过氧化速率,VE含量和硒谷胱甘肽过氧酶SeGSHPx活性的变化.结果表明血浆脂质过氧化物LPO含量增加,VE含量和SeGSHPx活性降低,以伤后10天为最显著:RBC的自发性溶血百分率和SeGSHPx活性增加,RBC VE含量降低。血浆和RBC的脂质过氧化速率增加和它们的VE含量降低的变化规律相一致。血浆LPO和VE含量以及SeGSHPx活性变化幅度与烧伤严重度相关。     

自由基脂质过氧化与甲状腺机能亢进症

本文测定了甲亢患者血浆脂质过氧化物含量、红细胞溶血程度以及血浆和红细胞硒谷胱甘肽过氧酶活性和维生素E含量,并对测定的结果及其意义进行了讨论.     

Low Cholesterol in Erythrocyte Membranes and High Lipoperoxides in Erythrocytes Are the Potential Risk Factors for Cerebral Hemorrhagic Stroke in Human

Objective:To explore the association of risk for human cerebral hemorrhage with blood cholesterol,free radicals,oxidatation and lipoperoxidation,Methods:351 cerebral hemorrhage patients(CHP) in the acute phase and 100 healthy adult volunteers(HVA) were investigated by testing the contents of cholesterol(CH),lipoperoxides(LPO),nitric oxide(NO),vitamin C(VC)and vitamin E(VE) and activities of superoxide dismutase(SOD) in plasma and erythrocytes (RBC),and by assessing the contents of CH and LPO in RBC with spectrophotometric assays.Results:Compared with the average vlaues(AV) of the above biochemical parameters(BP)in the HAV group,the AV of CH in plasma and RBC,VC and VE in plasma as well as SOD in plasma and RBC in the CHP group were significantly decreased(P=0.000),while the AV of the LPO in plasma and RBC as well as NO in plasma in the CHP group were significantly increased(P=0,0000),The findings of linear correlation analysis for the CHP group showed that the above biochemical parameters were significantly correlated with both intracraial hemorrhagic sized(IHS) and neurotic functional defective scales(NDS).The findings of stepwise correlation analysis for the CHA group suggested that HIS was closely correlated with the values of CH and LPO in RBC as well as NO and VE in plasma,and that NDS was closely correlated with the values of CH and LPO in RBC as well as NO and VC in plasma.Conclusions:The findings of the present study suggest that marked low RBC cholesterol and marked high RBC lipoperoxides may constitute the potential main risk factors for human cerebral hemorrhage,and that the oxidative and lipoperoxidative stress in the CHP bodies is pathologically aggravated.leading to the oxidative and lipoperoxidative damages in the CHP.     

促甲状腺素释放激素对严重烧伤大鼠组织含水量的影响

目的 探讨促甲状腺素释放激素（TRH）对严重烧伤大鼠组织含水量的影响并探讨其可能机制。方法 24只健康成年SD大鼠随机分为正常对照组、TRH治疗组和生理盐水（NS）对照组,复制大鼠40％TBAⅡ度烧伤休克动物模型,烧伤后0．5h给予TRH（5mg/kg体重）,观察烧伤前后平均动脉压的动态变化,检测烧伤后5h心、肝、肺、肾和创面含水量的改变,并观察血浆和脏器组织的超氧化物歧化酶（SOD）活力和丙二醛（MDA）含量的变化。结果 与NS对照组相比,TRH治疗后,大鼠的血压上升并维持在高水平,烧伤创面和内脏器官含水量明显下降,同时器官组织SOD活力上升,MDA含量下降。结论 TRH能抑制烧伤大鼠水肿的形成,具有抗渗出作用,这一作用可能与抗脂质过氧化损伤有关。     

严重烧伤休克期切痂对休克复苏影响的实验研究

目的 探讨烧伤休克期切痂的可行性及其对休克复苏的影响。方法 采用40%TBSAⅢ度烫伤犬模型,随机分为切痂组（E组）和非切痂组（C组）。伤后1h按Parkland公式补给平衡盐溶液,E组动物伤后3h切痂。分别于伤前及伤后30min和3、6、12、24、48h检测血流动力学、血液流变学业、氧代及血浆氧自由基变化。结果 烧伤后30min,CO明显下降,全血粘度、血浆粘度、红细胞聚积指数和血乳酸含量明显增加,切痂后,E组动物上述指标较C组明显改善。结论 休克期切痂能较早地纠正血流动力学、血液流变学紊乱及氧代谢障碍,减轻氧自由损伤,有利于烧伤休克的复苏。     

Studies on the Oxidative Stress in Alcohol Abusers in China

Objective:In order to study the relationship between alcoho abuse and oxidative stress,and to identify oxidative damage of alcoho abuse in human bodies.Methods:80 Cases of male alcoholics(AL) aged 40 years old and 80 cases of male healthy volunteers(HV)of the same age without drinking histroy were investigated by measuring concentrations of vitaminC(VC),vitamin E (VE) and β-carotene(β-CAR)in plasma as well as activities of superoxide dismutase(SOD),catalse(CAT) and glutathione peroxidase(GSH-Px)in RBC with spectrophotometri assays.Results:Compared with the average values(AV) of the above biochemical parameters in the HV group ,the average values of VC,VE and β-CAR in plasma and the activities of SOD,CAT and GSH-Px in RBC in the AL group were significantly decreased (P=0.0000),The findings in linear regression and correlation analysis for 80 alcoholics showed that with the prolonged drinking duration and increased daily drinking quantity,the values of VC,VE and β-CAR in plasma as well as SOD,CAT and GSH-Px in RBC in the alcoholics were gradually decreased(P=0.000),representing a respectively significant linear negative correlation.The analysis of stepwise regression and correlation rewvealed that the drinking duration had the closest correlation with the values of VE in plasma as well as CAT and GSH-Px in RBC,while the daily drinking quantity had the closest correlation with the values of VC,VE and β-CAR in plasma as well as SOD and GSH-Px in RBC,Conclusion :The findings of the present study suggested that the oxidative stress in the alcoholics became pathologically intensified,leading to potential oxidative damages in their bodies.Therefore,alcoholica should abstain from alcohol drinking,and should take as supplements suitable dosage of antioxidants per day such as VC,VE,β-CAR and others to moderate potential oxidative damages in their bodies.     

(英文)肾移植患者血清非对称二甲基精氨酸水平变化与内皮功能改善的关系

目的:探讨肾移植前后慢性肾衰患者血清非对称二甲基精氨酸(ADMA)水平变化与内皮功能改善的关系.方法:选择首次接受同种异体肾移植术患者38例和健康对照者36例.分别于移植术前、移植术后第1,3,7,14及28天抽血分离血清,高效液相色谱法(HPLC)检测血清ADMA和SDMA水平,硝酸还原酶比色法检测血清NO活性,DTNB法测定全血硒谷胱甘肽过氧化物酶 (SeGSHPx)活性,,硫代巴比妥酸法测定血清丙二醛(MDA)水平,ELISA法检测血清C反应蛋白(CRP)水平;移植术前及术后第28天多普勒超声法检测肱动脉内皮依赖性血管舒张功能(FMD).结果:肾移植术前患者血清ADMA[(2.36±0.89) μmol/L],SDMA[(0.48±0.11) μmol/L],MDA[(7.24±1.07) μmol/L]及CRP水平[9.24(0.42～66.24) μmol/L]明显高于年龄匹配的正常对照组[ADMA:(0.49±0.12) μmol/L;SDMA:(0.24±0.08) μmol/L;MDA:(3.12±1.21) μmol/L;CRP:2.52(0.24～5.94) μmol/L, 均P＜0.01],血清NO[(38.48±12.36) μmol/L] 及SeGSHPx[(104.23±14.46) U/L]活性、FMD(5.43%±1.87%)明显低于正常对照组 [NO:(70.13±12.46) μmol/L;SeGSHPx:(201.36±82.35) U/L;FMD:(10.11±1.64)%,均P＜0.01].移植术后第1天开始血清ADMA[(1.97±0.76) μmol/L],SDMA[(0.43±0.06) μmol/L],MDA[(6.24±0.82) μmol/L]及CRP[8.32(0.46～33.42) μmol/L]水平明显下降而血清NO[(42.63±11.32) μmol/L],SeGSHPx[(116.23±17.24) U/L]活性明显增高,第28天时除SDMA水平与对照组无差别外(P＞0.05),其余指标仍高于或低于正常对照组(P＜0.05).第28天时FMD(7.04±2.13)%较移植前明显增高但仍低于正常时对照组(P＜0.05).移植前后血清ADMA水平与MDA呈正相关,与SeGSHPx及FMD呈负相关.结论:慢性肾衰患者移植前后血清ADMA水平变化与内皮功能异常关系密切,并与氧化应激程度相关.     

烧伤大鼠脂质过氧化物含量的研究——Ⅰ.血浆、焦痂、肝组织脂质过氧化物及维生素E含量的动态变化

以5KW溴钨灯照射大鼠背部造成20％TBSAⅢ度烧伤。伤后1、2、3、5、7、9天活杀取血、焦痂及肝组织,以荧光分光光度计测定血浆、焦痂、肝匀浆、线粒体、微粒体、可溶部分中脂质过氧化物(MDA)以及维生素E。伤后血浆、焦痂、脂质过氧化物(LPO)含量升高。焦痂LPO含量有两个高峰:第一峰在伤后第二天(血浆LPO滞后一天),第二峰在伤后7～9天,与创面感染出现同时,在相当时相点可见肝匀浆、线粒体与微粒体亦出现类似的两个高峰,可溶部分LPO含量无明显改变。伤者见上述结构维生素E含量迅即下降,伤后3～5天达最低点,此后多维持在低水平。对烧伤后脂质过氧化的原因、对亚细胞结构的破坏作用作了简要讨论。     

中药川芎嗪对烫伤豚鼠肾脏保护作用的实验研究

目的　探讨中药川芎嗪对烫伤豚鼠肾脏的保护作用方法　复制 30% TBSAⅢ°烫伤豚鼠 78只,并随机分成川芎嗪 复苏(治疗组)和复苏 (对照组 ),每组均在烫伤后 2、48、12、24、48h6个时相点,分别采血 2~3ml,用放免法测血浆肾上腺髓质素 (ADM)、内皮素 (ET)数值;同时在伤后 412、24、48h4个时相点切取肾脏标本,用电镜观察肾脏超微结构改变;另设正常组。结果　①血浆ADM:伤后两组各时相点差异均有显著性 (P<0 05), 8h达峰值,两组比较对照组低于治疗组,在 8、12、48h各时相点差异有显著性 (P<0 05或P<0 01)。②血浆ET:两组各时相点均显著升高(P<0 01),治疗组升高明显低于对照组,在 8h内差异有显著性(P<0 05)。③肾脏电镜观察:两组伤后 4h即出现明显病理改变, 12h最严重, 48h后减轻。治疗组损害明显轻于对照组。结论　ADM与ET含量变化参与了烧伤休克的发病过程,中药川芎嗪可减轻严重烫伤后肾脏的损害,提高ADM与ET的比值,对烫伤动物豚鼠肾脏有保护作用,ADM有协同作用。     

血小板活化因子在烧伤大鼠早期肠源性内毒素血症发病中的作用

目的探讨血小板活化因子（ＰＡＦ）对烧伤后肠源性内毒素血症的影响。方法选用健康Ｗｉｓｔａｒ大鼠９０只制成３０％体表Ⅲ度烫伤模型,随机分为３组,正常对照组,单纯烫伤组,ＰＡＦ拮抗剂治疗组观察ＰＡＦ水平变化与肠源性内毒素血症的关系。结果大鼠烫伤后４８小时内肠粘膜通透性和血浆内毒素水平均显著升高,伤后１２小时为最高,分别为（０５８±０１８）ｍｌ·ｍｉｎ－１·１００ｇ－１、（１２９±２２）ｎｇ／Ｌ,与肠组织和血ＰＡＦ水平升高呈显著相关;ＰＡＦ拮抗剂治疗能显著降低肠粘膜通透性和血浆内毒素水平。健康大鼠静脉注射外源性ＰＡＦ后,肠粘膜通透性和血浆内毒素水平也显著升高,且与ＰＡＦ剂量呈显著依赖关系。结论大鼠烫伤后血浆及肠组织中ＰＡＦ水平升高是导致早期肠源性内毒素血症的一个重要因素。     

Heroin abuse and nitric oxide, oxidation, peroxidation, lipoperoxidation

To further reveal the risks of heroin abuse to human body, and to determine the injuries of oxidation, peroxidation and lipoperoxidation induced by nitric oxide and other free radicals to heroin abusers, we determined and compared plasma values of lipoperoxides (LPO), nitric oxide (NO), vitamin C (VC), vitamin E (VE), β-carotene (β-CAR) and erythrocyte values of LPO, superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-Px) in 114 heroin abusers and 100 healthy volunteers. Using linear regression and correlation as well as stepwise regression and correlation, we also analyzed the effect of the abusing duration, and daily abusing quantity on the above-mentioned biochemical parameters in the heroin abusers. The results showed that, compared with the healthy volunteer groups, the average plasma values of LPO, and NO, and the average erythrocyte value of LPO in the heroin abuser group were significantly increased (P＜0.0001), and the average plasma values of VC, VE, and β-CAR and the average erythrocyte values of SOD, CAT, and GSH-Px were significantly decreased (P＜0.0001). Analysis of linear regression and correlation showed that with prolonged heroin abusing and with increased daily quantity in the heroin abusers, the plasma values of LPO, and NO, and the erythrocyte value of LPO were gradually increased (P＜0.001), whereas the plasma values of VC, VE, and β-CAR and the erythrocyte values of SOD, CAT, and GSH-Px were gradually decreased (P＜0.001). Analysis of stepwise regression and correlation indicated that the plasma values of NO, VC and VE were closely correlated with the abusing duration and daily abusing quantity. These results indicate that the balance between oxidation and antioxidation in the heroin abusers was seriously disturbed, and the injuries induced by nitric oxide and other free radicals, through oxidation, peroxidation and lipoperoxidation to the bodies of heroin abusers exacerbated. It is therefore necessary that in abstaining from heroin dependence, the heroin abusers should acquire sufficient quantities of antioxidants such as VC, VE and β-CAR.     

Changes of Liver Microsomal Drug-metabolizing System and Lipoperoxidation Activity in Scalded Rats and the Effects of Silybin

The dynamic changes of liver microsomal drug-metabolizing system (MDMS) andlipoperoxidation were studied in scalded rats. The effects of treatment with vitamin E and silybinwere also evaluated. The results showeed that liver microsomal cytochrome P-450 content, and p-nitroanisole demethylase (P-NOD) and aniline hydroxylase (AH) activity decreased markedlypostburn. On the contrary, liver lipoperoxide and mierosomal lipoperoxidation increased significantlyafter scalding. Both the increase of liver lipoperoxide and mierosomal lipoperoxidation and the de-crease of MDMS activity were prevented by vitamin E and silybin treatments.     

烫伤后大鼠肝脏药物代谢酶和脂质过氧化活性的变化以及水飞蓟宾的作用

用Sprague-Dawley大鼠制成体表面积10％～15％深Ⅱ度烫伤,观察肝脏药物代谢酶和脂质过氧化活性的变化,并观察维生素E、水飞蓟宾对上述变化的影响。实验结果发现烫伤后肝微粒体细胞色素P-450含量及活性明显降低,同时伴有肝脂质过氧化活性增高。维生素E和水飞蓟宾能抑制烫伤后肝脂质过氧化活性的增高,并对肝脏药物代谢酶活性有保护作用。     

A study of pathological changes and their mechanisms of the thyroid after severe burns in rats

Full thickness burns of 30% TBSA by napalm was inflicted to rats and the pathologi-cal changes of the thyroid were observed with optical and electron microscopy and with peroxi-dase histoehemistry for 15 days postburn.Dynamic changes of the serum level of T_3 and T_4 wereobserved concomitantly.It was found that the postburn pathological changes of the thyroid couldbe distinguished into 3 phases as follows:The phase of injury inhibition.This lasted from the 2nd to the 24th hour postburn and wascharacterized by marked damage of the follicular epithelium.The phase of structural and functional recovery.This lasted from the 3rd to 6th day post-burn and was characterized by abated damage of the thyroid and a tendency to recover.The phase of active function.This lasted from the 10th to the 15th day postburn.The syn-thesizing and releasing organellae of the thyroid were well-restored.The changes of T_4 were parallel to the pathological changes of the thyroid in all the stages,while T_3 level was continously inhibited because of the low serum level of T_4,the metabolic dis-turbance of T_4 deiodination,and the inhibition of thyroid secretion in the early postburn stage andthe metabolic disturbance of T_4 deiodination in the middle and late postburn stages.In the earlypostburn stage,the inhibition on thyroid peroxidase was an important factor to inhibit the func-tion of the thyroid.     

家兔烧伤后血浆内毒素和丙二醛水平及早期切痂对其影响

通过复制创面绿脓杆菌感染、背部Ⅱ度30％体表面积烧伤的家兔动物模型，动态检测了烧伤动物血浆内毒素及MDA含量的变化。结果表明：烧伤创面及感染是血中内毒素和氧自由基的重要来源；早期切痂能降低血内毒素和MDA水平。对内毒素影响氧自由基形成及早期切痂影响血中内毒素和MDA水平的机理作了初步探讨。     

大鼠严重烧伤后胃,十二指肠粘膜的扫描电镜观察

扫描电镜观察结果显示,两致伤组胃和十二指肠粘膜损害分为水肿、轻度坏死和重度坏死三型。胃粘膜轻度坏死,伤后早期较重,中间轻,后期加重的“马鞍状”。重度者发生较晚,见于24和72 h。十二指肠绒毛,伤后立即水肿伴轻度坏死,2 h重度坏死,24 h达高峰,72 h略减轻。十二指肠粘膜损害发生早、持续时间长、发病率高、程度严重。磷烧伤组胃肠改变较凝固汽油严重。主要原因是热应激反应及磷元素和磷自由基的毒作用;磷自由基较磷元素本身毒性更大。     

Oxidative Stress in Patients With Acute Coxsackie Virus Myocarditis

To study the state of oxidative stress in patients with acute coxsackie virus myocarditis (ACM), and to investigate the pathological chain reactions of a series of free radicals and oxidative and lipoperoxidative damages in their bodies. Methods Eighty ACM patients and 80 healthy adult volunteers (HAV) were enrolled in a case-control study, in which concentrations of nitric oxide (NO) in plasma, lipoperoxides (LPO) in plasma and LPO in erythrocytes (RBC), vitamin C (VC), vitamin E (VE) and β-carotene (β-CAR) in plasma as well as activities of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-Px) in RBC were determined by using spectrophotometric assays. Results Compared with the average values (AV) of the above biochemical parameters (BP) in the HAV group, the AV of NO in plasma, and LPO in plasma and RBC in the ACM group were significantly increased (P=0.0001), while the AV of VC, VE, β-CAR, SOD, CAT and GSH-Px in the ACM group were significantly decreased (P=0.0001). The values of the above BP were used to estimate the relative risk ratio (RR) between the ACM group and the HAY group; the RR and its 95 % confidence interval were 12.467 (5.745～27.051), 4.333(2.126～8.834), 6.517 (3.225～13.618), 3.310 (1.598～6.858), 31.000 (12.611～76.201),4.663 (2.228～9.759), 11.769 (5.440～25.462), 3.043 (1.486～6.229) and 6.594 (3.045～14.281)respectively, and their P levels ranged from 0.002 to 0.0001. The results were asfollows: D = 22.143 - 0.017SOD + 0.008NO + 0.244LPO in RBC, Eigenvalue = 13.659,Canonical correlation = 0.965, Wilks' λ = 0.068, χ2 = 420.212, P = 0.0001. The correct rate of discrimination to the ACM group and to the HAV group was 87.5% and 95.0 %, respectively,and 91.3 % of originally grouped cases was correctly classified. Conclusion The findings in this study suggested that the oxidative stress in bodies of ACM patients was severely aggravated, and marked high oxidative constituents and low antioxidants and antioxidases in the human body might increase the relative risk of inducing acute coxsackie virus myocarditis, and measuring the values of NO in plasma, SOD and LPO in RBC might increase the correct rates of discriminatory analysis of the ACM.     

川芎嗪对严重烫伤豚鼠早期血浆心钠素含量变化的影响

目的　观察严重烫伤豚鼠早期血浆心钠素的含量变化及川芎嗪对其影响。方法　复制 3 0 %TBSA三度烫伤动物 (豚鼠 )模型 ,随机分成复苏组和川芎嗪治疗组 ,每组均在烫伤后 2 ,4,8,12 ,2 4,48h六个时相点 ,抽腹腔静脉血2 -3ml ,用放射免疫法测定血浆ANP浓度。另设正常对照组。结果　两组血浆ANP均在伤后 2h显著升高 (P <0 .0 1) ,4h后开始下降 ,8-2 4h下降显著 (P <0 .0 5 ) ,48h后又开始回升 ;但治疗组从 4h后含量明显高于复苏组。结论　烫伤豚鼠早期血浆ANP分泌量降低 ,中药川芎嗪可促进ANP的分泌。提示重度烧伤早期应用中药川芎嗪有重要的临床价值。     

烧伤合并吸入性损伤病人的肺功能检测

报道了36例烧伤病人的肺功能检测，结果：（1）中等面积，大面积烧伤和体表烧伤合并吸入性损伤患者用力肺活量（FVC），第1秒时间肺活量（FEV1.0，呼出50%肺活量时的呼气流速（FEF50%），呼出75%用力肺活量时的呼气流速（FEF75%）降低，于伤后50h降至最低值；（2）中等烧伤面积组伤后10d时FVC，FEV1.0，FEF50%，FEF75%有所回升；至伤后30d恢复正常；（3）大面积烧伤和体表烧伤合并吸入性损伤组伤后50h和10d均明显降低；伤后30d有所升高，除大面积烧伤组FVC伤后30d时FVC已恢复正常外，均未达到正常范围；（4）体表烧伤合并吸入性损伤组的各时点所观察的肺功能参数下降较大面积烧伤组更为明显，采用微型肺量计检测对监护烧伤病人肺功能具有一定临床意义。     

血液稀释治疗对急性脑梗塞血浆激肽释放酶原、蛋白C和蛋白S含量的影响

对16例接受等容血液稀释治疗及15例接受常规治疗的急性脑梗塞患者分别在治疗前、治疗后第5d和第30d检测血浆激肽释放酶原(PK)、蛋白C(PC)和蛋白S(PS)含量,并以20名健康者作正常对照。结果显示,治疗前两组患者各项指标均在正常范围,治疗后第5d稀释治疗组血浆PK含量显著下降(P<0.05),治疗后第30d稀释治疗组PC含量显著下降(P<0.05),未经稀释治疗的病例其相应指标无显著性变化。提示血液稀释疗法可能有提高脑梗塞患者抗凝系统的活性及调节凝血系统和抗凝系统平衡的作用。