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为探讨严重烧伤延迟复苏血清粒缅胞集落刺激因子(G-CSF)的变化规律及其与感染发生、发展、预后的关系。采用大鼠30%TBSAⅢ度烧伤模型,动态观察了大鼠在立即复苏与延迟复苏两种条件下,外周血白细胞数量,血清(G-CSF)和肿瘤坏死因子-α(TNF-α)含量,中性粒细胞吞噬功能;采用大鼠30%TBSAⅢ度烧伤延迟复苏合并早期创面感染模型,动态观察应用重组粒细胞-巨噬细胞集落刺激因子(rhGM-CSF)对改善大鼠存活率的影响。结果表明:延迟复苏组动物血清 G-CSF 峰值后移,血清 G-CSF 含量,中性粒细胞吞噬功能,外周血白细胞计数均低于立即复苏组。死亡组动物表现为低血清 G-CSF,高血清 TNF-α。应用 rhOM-CSF 能够改善严重烧伤延迟复苏伴早期创面感染大鼠的存活率。提示:严重烧伤后延迟复苏并发创面脓毒症的发生与机体 G-CSF 产生减少有关,GM-CSF 应用为其开辟了一条新的治疗途径。
To investigate the variation of serum granulose-derived colony-stimulating factor (G-CSF) and its relationship with the occurrence, development and prognosis of severe burn in delayed resuscitation. Using 30% TBSA Ⅲ degree burn model in rats, the number of white blood cells, serum G-CSF and tumor necrosis factor-α (TNF-α) were dynamically observed in rats under both immediate and delayed resuscitation. Neutrophil phagocytosis was observed. The effect of rhGM-CSF on the survival rate of rats was dynamically observed by delayed resuscitation combined with early wound infection in 30% TBSA severe burn in rats. The results showed that the serum G-CSF peak value, serum G-CSF content, neutrophil phagocytic function and peripheral blood leukocyte count in delayed resuscitation group were lower than those in immediate resuscitation group. The animals in the dead group showed low serum G-CSF and high serum TNF-α. Application of rhOM-CSF can improve the survival rate of rats with delayed wound healing after severe burn with early wound infection. It is suggested that delayed resuscitation after severe burn complicated with wound sepsis is related to the decrease of G-CSF production. GM-CSF application opens up a new therapeutic approach.