| Objective:Microvascular permeability after serious burns can cause low blood hypovolaemic shock and organ dysfunction. In severe burns, we haven’t find a effective method to prevent the increase of vascular permeability increase and mass exosmosis of intravascular fluid; we only infuse mass fluid to compensate for the loss of intravascular fluids according to the area and depth of burns.The change on the structure and function of microcirculation is one of main mechanisms which is pathophysiological of burn shock. Fundamental changes of microcirculation are the following respects:First, irrigation decreases, because the early vascular contracts and plasma exuds. Second, capillary and micro venous wall endothelial cell are damaged, which makes vascular permeability and mass exosmosis of intravascular fluid. That aggravates reduction of cycle blood.Third, capillary broadens and vascular capacity increases in the middle-late of shock response, which makes effective circulation further reduced. Fourth, plasma is lost, which makes haematocrit increases and cells gathered easily.We haven’t stop looking for effective methods to do better to the microcirculation and repress the rise of vasopermeability after burn, which may delay the development of shock, decrease the volume of resuscitation fluid, and improve the edema of organs. In this study, we used rabbits of35%TBSAⅢ as models. We observed the influence of shenmai injection and xuebijing injection, as used to the models early after burn, to the pristine dynamic change of endothelin-1、nitric oxide and tumor necrosis factor-α. On the basis of above study, relevant mechanisms of two drugs functions were disused. We hope to provide experimental evidence for doing better to the microcirculation and repressing the rise of vasopermeability when they were used during early stage of burn shock.Methods: 1Grouping the experimental animals:32healthy grownup rabbits, both male and female would work. No pregnant female rabbits. Rabbits were divided into sham injury group (n=8), burn group (n=8), Shenmai group (n=8) and Xuebijing group (n=8).2Preparation before the experiment:weighting the rabbits, number them, Injury area was30%; draw back about30%of injury range body; and hair removal was about40%,which belly with8%sulfureted natrium liquor, then use physiological salt water to wash them on dry them.3Copy of30%TBSA Ⅲ degree scald models:using1%amyl barbital natrium liquor to narcosis the rabbits, then they were put into constant temperature(92℃) water-bath for20s to make Ⅲ degrees burn models,and recover them just now. After that, the models are done.4Time to exsanguinate the rabbits:pre-burn (0h),6hours after burn (6h),12hours after burn (24h),24hours after burn (24h),48hour after burn (48h). Shenmai group were given intravenous infusion with the solution of2ml/kg of Shenmai diluted to20ml with isotonic saline. The infusion was conducted3times a day for2days; in Xuebijing group, the rabbits were given intravenous infusion with the solution of2ml/kg of Xuebijing diluted to20ml with isotonic saline,3times a day for2days, then to exsanguinate them with the method above.5Checking:put all the blood into centrifuge (1500r/min,10min),take away the serum, put the serum in frig(-70℃),after the whole work done, check the index. check the consistency of ET-1、NO、TNF-αin plasma on different times respectively,in order to know the change of consistency after electroshock and the effect of shenmai injection and xuebijing injection. Use ELASA to check TNF-α ET-1,and check NO by a method of nitrate reductase enzymatic.6Experimental DP:statistically analysis all the data with SPSS13.0.All the data should be present in average standard differences,2independent samples of different groups should checked in t-checking, the even data should be check in its own manner, vice versa. If p<0.05, then it has statistical meaning.Result:1. The content of ET-1:The level of ET-1in serum after severe burn in groups of shenmai、xuebijing and burn ones go up,but the pace of shenmai group and xuebijing group is slower than burn group; The level of ET-1in three groups reached the highest at the time point of12th h post-injury. At the time point of24th and48th h post-injury, the level of ET-1in Shenmai group and Xuebijng group were significantly lower than that of scald group (P<0.01), But there was no significant difference of level of ET-1observed between Shenmai group and Xuebijng group (P>0.05)2The content of NO:The level of NO in serum after severe burn in groups of shenmai、 xuebijing and burn ones reached the highest at the time point of6th h post-injury. At the time point of24th and48th h post-injury, the level of NO in Shenmai group and Xuebijng group were significantly lower than that of scald group (P<0.01), But there was no significant difference of level of NO observed between Shenmai group and Xuebijng group (P>0.05)3The comparison of ET-1/NO:The level of ET-1/NO after severe burn in groups of shenmai、xuebijing and burn ones go up; The level of ET-1/NO in three groups reached the highest at the time point of12th h post-injury. At the time point of24th and48th h post-injury, the level of ET-1/NO in Shenmai group and Xuebijng group were significantly lower than that of scald group (P<0.01), But there was no significant difference of level of ET-1observed between Shenmai group and Xuebijng group (P>0.05)4. The content of TNF-a:The level of TNF-a in serum after severe burn in groups of shenmai、xuebijing and burn ones go up,but the pace of shenmai group and xuebijing group is slower than burn group; The level of ET-1in three groups reached the highest at the time point of12th h post-injury. At the time point of24th and48th h post-injury, the level of TNF-a in Shenmai group and Xuebijng group were significantly lower than that of scald group (P<0.01), But there was no significant difference of level of TNF-a observed between Shenmai group and Xuebijng group (P>0.05)Conclusion:1.Both of shenmai injection and xuebijing injection could restrain the level of ET-1、 NO、TNF-α, and balance ET-1/NO ratio. Shenmai injection could do better to the microcirculation, repress the rise of vasopermeability and play a protective role in endothelial cells.2. Shenmai injection and xuebijing injection may have some active clinical meanings in treating to repress the rise of vasopermeability caused by severe burn cases in their early time. |
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