The Effect Of Early Use Of Meropenem And Great Dose Of Recombinant Human Growth Hormone On The Enterogenic Infection And Prognosis In Severely Scalded And Immunosuppressive Rats

ObjectiveIt is always one of the investigation hot spots that how to prevent and cure the enterogenic infection in severely scalded patients. There is dispute in the use of the broad-spectrum antibiotic to aim directly at the microbial population in the gut,and it is only have some degree of utility ,but to solve the problem at all is to promote the impaired intestinal mucosal barrier to repair at the same time.It has been proved that growth hormone(GH) can accelerate growth and wound healing,improve anabolism,as well as has important protection to the intestinal tract.This study is aimed to explore the therapeutic effect and prognosis of early (2 postburn hours,PBHs) use of meropenem (MEP) and great dose of recombinant human growth hormone(rhGH) to treat the severely scalded and immunosuppressive rats.Methods132 adult male Wister rats were randomly divided into control(A), scalded(B)and treated(C₁=rhGH,C₂=MEP,C₃=MEP+rhGH) groups,the latter two groups each were divided into 8,24 PBHs and 4,7,14 postburn days(PBDs) groups,there are 6 rats in every group.After being anesthetized with ketamine (100mg/kg),rats in the latter two groups were made to 25%TBSA â…¢ degree scalded injury on the backhand immediately followed by intraperitoneal injection of dexamethasone (80mg/kg) to induce immunosuppression,as well as normalsaline(NS)(50ml/kg) to prevent shock.The wound was applied with iodine tincture(2%) at once,and followed with once every 8 hours.The exprement was devided into two sections.l.The effect of early use of MEP and great dose of rhGH on the enterogenic infection in severely scalded and immunosuppressive rats. At 2 PBHs,hypodermic injection rhGH 1.33IU/kg and intramuscular injection MEP 20mg/kg on the rats in group C single time,while the rats in other groups were given normal saline(NS). Then detected these items at 8 and 24 PBHs by methods of radioimmunodetection, biochemistry, bacteriology and so on : the level of lipopolysaccharide/endotoxin(LPS) in portal and caval vein and the tumor necrosis factor alpha(TNF-a) in caval venous serum ;the hepatic function;and the rate of the intestinal bacteria translocation in the mesenteric lymph node(MLN),liver and kidneys.2.The effect of early use of MEP and great dose of rhGH on gut derived sepsis and the prognosis in severely scalded and immunosuppressive rats. The rats in group C were given MEP and rhGH fore 3 days,while the rats in other groups were given NS at the same time.Then detected these items differently at 4,7,14PBDs by methods of diagnostics,pathology,bacteriology,biochemistry and so on: the rate of the intestinal bacteria translocation in the MLN,liver,kidneys,spleen,lung,portal and caval venous blood;the incidence rate of abcess in liver,kidneys,spleen and lung;the functional changes of liver and kidneys;the changes of weight and respiration;and the survival rate.Results1. The effect of early use of MEP and great dose of rhGH on the enterogenic infection in severely scalded and immunosuppressive rats. The levels of LPS and TNF-a in the rats of MEP+rhGH group were markedly lower than that in other groups (P<0.01—0.001),while had not statistically significant difference with the control group (P>0.05) .we had not found the bacterial translocation from intestine in the MEP+rhGH group .The indices of hepatic function at 8 PBHs were higher in the MEP+rhGH group than that in contral group but hand no significant difference (P>0.05),while significant lower than that in other groups(P<0.01),at 24 PBHs,it had no significant difference between the MEP+rhGH and control group.2. The effect of early use of MEP and great dose of rhGH on gut derived sepsis and the prognosis in severely scalded and immunosuppressive rats. We had not found abscess in organs or the bacterial translocation from intestrine in the MEP+rhGH group.The weight descent in rats of MEP+rhGH group markedly lower than in other groups(P<0.01⁰.001).The changes of respiration in rats of MEP+rhGH group were not significant difference with the control group ( P > 0.05 ) .The pathohistological constructions of organs and tissues in rats of MEP+rhGH group were near the normal rats.The changes of the function of liver and kidneys were not significant between the MEP+rhGH and control group (P>0.05) .There had no rat exhaustion or dead in the MEP+rhGH group.Conclusions1. Early use of MEP and great dose of rhGH to treat severely scalded and immunosuppressive rats,it could markedly reduce or prevent the intestinal bacteria/endotoxin translocation,decrease the release of mediators of inflammation, consquently protect the hepatic function.2. Early use of MEP and great dose of rhGH could effectively protect the intestinal tract and prevent gut derived sepsis in the severely scalded and immunosuppressive rats,the prognosis of this model was eusemia.