The Study On Protective Effect Of Early Use Of Insulin And Recombinant Human Growth Hormone On Intestinal Mucosa In Severely Scalded Rats

Objective:After severe burns, the body can cause a strong stress response, gut barrier damage in particular, mechanical barriers, leading to increased intestinal permeability, triggering gut-derived sepsis, septic shock, multiple organ dysfunction syndrome (MODS) and many other complications. Intestinal is a surgical stress central organ and the body's largest reservoir bacteria library, how to maintain and restore as soon as possible after severe burn barrier function of intestinal morphology integrity, is an important report on prevention and treatment of intestinal infection. The current study utilized severely scalded rats model which can lead to gut injury and gut original infection, investigate the effects of recombinant human growth hormone (rhGH) combined with intensive insulin therapy on intestinal epithelial cells in early severely scalded rats and provide experimental evidence for prevention and treatment of intestinal infection.Methods:78 adult male Wistar rats were randomly divided into five groups:the control group (group A,n=6), the scalded group (group B,n=18), the treated groups (C1=rhGH,C2=insulin,C3=rhGH+insulin), and the latter two groups each were divided into 12,24,48 PBHs groups. The rats in the latter two groups were subjected to 25% TBSA full-thickness scald on the back, received intraperitoneal injection of 50 ml/kg isotonic saline to prevent shock, and intraperitoneal injection of dexamethasone (80mg/kg) to induce immunosuppressoion. The rats in group C1,C3 received subcutaneous injection of rhGH(1.33IU/(kg-d)) 2 hours after scald,then the rats in group C2,C3 were subcutaneous injection of insulin according to the blood glucose value tested before each meal. At 12h,24h,48h after scald, the intestinal mucosal histomorphology in ileum tissues, changes in the number of apoptotic cells, the level of D-lactic acid and DAO in blood were observed by HE stain, TUNEL and other methods, respectively.Results:Compared with the control group, the burn groups and the treated groups significantly damage intestinal morphology, while the treated group C3 less injury. At each time point after scald, the number of intestinal epithelial cells, the contents of D-lactic acid and diamine oxidase in the burn groups and the treated group increased significantly compared with the control group (P<0.01), while the treated group C3 was lower than the other groups (P<0.05, P<0.01). Compared with the control group at each time point after scald, the blood glucose level in the burns groups and the treated group C1 was significantly higher (P<0.01), while the blood glucose level in the treated group C2,C3 changed in the normal range, and the difference was not statistically significant.Conclusions:The administration of insulin combined with rhGH for severely scalded rats, can reduce the injury on intestinal mucosal barrier fuction and alleviate the hyperglycemia induced by growth hormone.