摘要
目的：研究不同剂量胰岛素对严重烫伤早期血清IL-1β及IL-10的影响．方法：将雄性SD大鼠63只随机分为烫伤后盐水治疗（A）组、盐水＋不同剂量胰岛素治疗（B1～B3）组，每组14只，另取7只正常大鼠作为对照（N）组．烫伤各组在背部造成约30％体表总面积（TBSA）全层皮肤烫伤．伤后6，24h后检测血糖、血压及血清IL-1B及IL-10含量．结果：伤后大鼠血糖明显升高，6h达到（10．7±1．8）mmol／L，并持续高血糖状态，胰岛素可以降低伤后血糖，并随剂量的增大而作用增强，3IU／kg胰岛素的6h血糖为（6．0±0．8）mmol／L，与正常值（5．1±0．6）mmol／L比较无统计学差异（P〉0．05）；伤后6，24h血压均明显低于正常值，3IU／kg胰岛素对伤后血压有显著改善作用．烫伤后血清IL-1β显著升高，不同剂量胰岛素干预均可降低IL-1β水平（P〈0．05或P〈0．01），3IU／kg时血清IL-1β在6，24h分别为（54．0±8．6），（46．8±6．8）ng／L．烫伤后血清IL．10含量有所升高，胰岛素可进一步提高烫伤大鼠血清IL-10含量，以3IU／kg伤后24h最为明显，达到（45．5±5．2）ng／L，与单纯盐水治疗组相比差异非常显著（P〈0．01）．结论：严重烧伤早期时不同剂量胰岛素干预可调节血清促炎／抗炎性细胞因子水平，减轻伤后机体的炎症反应，当血糖控制在正常范围时其作用最为明显．
AIM： To determine the possible effects of different doses of insulin on the pro-inflammatory cytokine IL-1 β and the anti-inflammatory cytokine IL-10 in early stage of severe burn in rats. METHODS： Male Sprague-Dawly rats （30% TBSA, full thickness burn） were randomly divided into 2 groups to receive either normal saline only （n = 14, with intra-peritoneal injection of 40 mL/kg normal saline, group A） or normal saline plus different doses of insulin （ n = 42, with intra-peritoneal injection of 40 mL/kg normal saline plus subcutaneous injection of 1, 3 or 5 IU/ kg insulin respectively, group B1, B2, B3）. In addition, 7 rats without thermal injury were subjected to normal control group （group N）. The outcome measures encompassed the serum glucose, blood pressure, serum IL-1β and IL-10 in rats at 6 and 24 h after scald and different treatments. RESULTS： The serum glucose increased quickly in rats after scald, which was demonstrated in group A to a range of （10.7±1.8） mmol/L by 6 h post-scald. Insulin decreased the serum glucose in a dosedependent manner in rats of group B1, B2 and B3. And insulin at a dose of 3 IU/kg body weight reduced the serum glucose to a range of （6.0±0.8） mmol/L in rats at 6 h after thermal injury, which was almost eqeal to the normal range of （5. 1± 0. 6 ） mmol/L （P 〉 0.05 ）. Meanwhile, insulin at this dose improved the blood pressure of scalded rats by keeping the blood pressure at a stable condition similar to the normal. Insulin significantly decreased the serum IL-1 β in a dose-dependent manner in scalded rats. It was partially showed after administration of insulin of 3 IU/kg serum IL-1β was （54.0 ＋8.6） ng/L and （46.8 ＋6.8） ng/L, much lower than that without insulin administration in rats at 6 and 24 h after thermal injury （P 〈0.01 ）. Insulin could increase the serum IL-10 in scalded rats. In comparison with group A, the most significant increase of serum IL-10 was seen by application of 3 IU/kg insulin as （45.5 ＋5.2） ng/L in rats 24 h after scald （P 〈0.01 vs group A）. CONCLUSION： Our data provided an insight that insulin might attenuate the inflammatory cascade response by decreasing the pro-inflammatory cytokine IL-1β and increasing the anti-inflammatory cytokine IL-10, thereby keeping or restoring the systemic homeostasis after severe burn. The best administration dose of insulin in early burn stage should be determined by normalizing serum glucose.
出处
《第四军医大学学报》
北大核心
2006年第22期2043-2046,共4页
Journal of the Fourth Military Medical University
作者简介
王耘川．硕士生．（029）84775298,Email：wyc411@fmmu．edu．cn
贾赤宇 导师
通讯作者：胡大海．Tel：（029）84775298,Email：bums@fmmu．edu．cn
