Study On The Relationship Between The Changes Of Zinc, Zn-linking Functions And MOF After Severe Trauma

Backgroud: severe trauma can lead to the high rate of Nosocomial infectious and multiple organ dysfunction syndrome (MODS), even death during the course of routine therapy. So this issue have a widespread attention for the researchers. The mechanism of MODS is very complicated, Nowadays it is widely accepted that the unbalance between the reactions of accelerating inflammation and resisting inflammation is probably the pathologic and physiologic foundation . The researchers advanced many hypotheses on the mechanisms of MODS after more than twenty years' exploration, but the relationship between acute trace elements deficiency and MODS after severe trauma has not be mentioned.It is indicated that systemic inflammatory reaction syndrome (SIRS) is the common passway to MODS. SIRS is induced by the strength of accelerating inflammation reaction and the weakness of resisting inflammation reaction.The former is caused by TNFα, IL-1, IL-6, IL-8 and NO, oxygen-derived free radidicals etc, the latter is the decrease of immunity. Zn is one of the important trace elements, having a significiant influence on antioxidant and immunity. It is confirmed that acute zinc deficiency can be induced by trauma, stress and infection.The purpose of this experiment is to establish the model of rabbit severe trauma, and detect the level of Zn and Zn-linking antioxidant and immunity, discussing the relationship between acute trace elements deficiency and MOF after severe trauma.Materials and methods: 40 male purebred New Zealand white rabbits .6 rabbits were assigned in slight trauma group, and 28 ones in severe trauma group (10 ones for collecting blood and 18 ones for killed ), 6 ones in control group at random. 7 dead rabbits in severe trauma group wereassigned in dead group. The collected blood is used to detect the level of zinc and Cu/Zn-SOD before trauma and 12 hours, 36hours, 60 hours and 6 days ,9days,14days,28 days after trauma; Brain ^ heart > lung and liver were extracted to detect the level of Zn and MT in liver before trauma and 12 hours,60 hours, 6 days, 14 days after trauma; At the same time, brahK hearU lung> liver n kidney > thymus and spleen are extracted for HE coloration, spleen for electron microscope, thymus and spleen for TUNEL coloration to detect the apoptotic lymphocytes. Results1. clinical manifestationIn slight trauma group, the rabbits have no abnormality in vital signs and weight, no death; In severe trauma group, the rabbits have an obvious decrease in weight, 7 rabbits were dead among the 20 ones (not including the 8 ones executed in the first three days), the mortality was 35%.2. Zn content in serum and organsZn in serum decreased from the first day till the sixth day in slight trauma group, but till the first two weeks, P<0.01,and the first four weeks, P<0.05 in severe trauma group. Zn in liver increased from the first day and in peak till the third day, then decreased to normal; The tendency of Zn content in brain > heart and lung is the same as in liver.3. The level of MDA and Cu/Zn-SOD in serum and liverMDA content in serum increased from the third day and in peak till the sixth day, then decreased to normal in severe trauma group; The activity of Cu/Zn-SOD in serum decreased in the first day, P>0.05, but increased significantly in the first two weeks, PO.01, then decreased to normal in severe trauma group. The activity of Cu/Zn-SOD in liver increased in the first day, P>0.05, then decrease. The activity of Cu/Zn-SOD in serum of the dead rabbits decreased significantly in the first day, PO.001, and decreased continuously.The rabbits were all died between the 4-6 days after severe trauma.4. The level of MT in liverThe level of MT in liver increased from the first day and in peak till the sixth day, then decreased to normal.5. Morphologic changesThe wound in Nuchae was healed up, Soft tissues in fracture area are filled with big dark red ecchymosis, no edema and infectious signs. We found that lung was filled with petechia and ecchymosis, coagulum in cardiac chamber after death, congestion and little pale necrosis in liver. It is observed through microscope that the parenchyma cells are all filled with edema and inflammation, which is accordance with the manifestation of MOF.6. changes of immunological organsThe weight and exponent of thymus decreased, but spleen didn' t decrease significantly. The apoptosis of ymphocytes increased in thymus and spleen through HEn electron microscope and TUNEL, and the changes in dead group were the most significant. Conclusions1. There existed acute trace elements deficiency after severe trauma, the degree of serum zinc content decreased is positive correlation with the degree of trauma.2. The level of Cu/Zn-SOD in serum and liver and MT in liver increased ,but the increase of Cu/Zn-SOD is the most significiantThe activity of Cu/Zn-SOD in dead rabbits decreased significantly after severe trauma, which may be induced by acute zinc deficiency.3. Thymus and spleen are both atrophy after severe trauma, but the apoptotis of lymphocytes in thymus is more significantly.4. Acute TE dificency may be one of the important causes of nosocomial infectious disease and MOF after severe trauma...