Objective: To observe the changes in c-fos protein expression in kidney tissue of rats after severe burn with delayed fluid resuscitation (DFR) in areas of different altitude,and explore the relationship between its expression and cell apoptosis. Methods: The experiments were performed at altitudes of 1 517 m and 3 848 m. At the area of the respective altitude, 120 Wistar rats were randomly divided into 3 groups: ① Immediate fluid resuscitation (IFR) group (n2 = 60) : rats were exposed to 30% total body surface area thermal injury (90 ℃ hot water,20 seconds) followed by peritoneal injection of normal saline (4 ml/kg) immediately after burn. ②DFR group (n = 50): after the same injury in IFR group, normal saline was instead injected peritoneally 6 hours after burn. ③Sham-injured group(n = 10) : the rats were sham-injured (37 ℃ water,20 seconds) without fluid injection. The apoptosis of renal cells was assessed by TUNEL,the expression of c-fos protein in kidney tissue was assessed by immunohistochemistry staining and image analysis system 1,6,12,24,72 and 168 hours after burn,and 1 hour after sham injury. The apoptosis index was calculated. Results: At the same altitude,the renal cells apoptosis index and the expression of c-fos protein in DFR group were enhanced compared to those of the IFR group, and they were higher than those of the sham-injured group (P<0. 001). The parameters mentioned-above were higher in high attitude groups compared with those in low attitude groups(P<0. 001). The cells apoptosis was positively correlated to the expression of c-fos protein(r = 0. 968,P<0. 001). Conclusions: Severe burn at the area of high attitude results in high expression of c-fos and an increase in apotosis of kidney cells,and the expression of c-fos is correlated with renal cell apoptosis. Delayed resuscitation could aggravate the apoptosis of kidney cells.%目的:探讨高原不同海拔地区大鼠严重烫伤延迟复苏后肾脏组织c-fos蛋白的表达规律及其与肾组织细胞凋亡的关系.方法:雄性Wistar大鼠240只,分别在1517 m和3 848 m两个海拔高度进行实验,每个海拔高度的大鼠(n=120)均随机分为3组:①即时复苏组(IFR组,n=60):伤后即刻腹腔注射等渗盐水4 ml/kg;②延迟复苏组(DFR组,n=50):伤后6 h开始按4 ml/kg补液;③假伤组(n=10):大鼠背部置于37 ℃水浴中20 s模拟烫伤,不补液.IFR组和DFR组大鼠将背部浸于90 ℃热水中20s建立30% TBSA Ⅲ度高原烫伤模型,分别于伤后1、6、12、24、72和168 h取肾组织,假伤组大鼠于模拟烫伤后1 h取肾组织,采用原位末端标记法(TUNEL)检测肾组织细胞的凋亡,计算凋亡指数;免疫组织化学染色与图像分析技术检测肾组织c-fos蛋白的表达.结果:肾组织细胞凋亡指数和c-fos蛋白表达水平在相同海拔高度DFR组和IFR组均高于假伤组,且DFR组均高于IFR组,高海拔地区高于低海拔地区(P<0.001);细胞凋亡指数与c-fos蛋白表达水平呈明显的正相关(r=0.968,P<0.001).结论:高原严重烫伤可导致 c-fos蛋白的表达增强,同时伴肾组织细胞凋亡加剧,延迟复苏较即时复苏加重细胞凋亡;c-fos蛋白的表达与高原严重烫伤大鼠肾组织细胞凋亡相关.
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