盐酸戊乙奎醚对严重烧伤患者早期切痂植皮术后炎性及应激反应的影响

摘要

Objective To study the effecl of penehyclidine hydrochloride ( PHC) on inflammalory and slress reaction in severe burn palienls undergoing early escharectomy and skin grafling. Methods Forty severe burn palienls undergoing early escharoctomy and skin graft were randomly divided inlo Lwo groups of 20 each: penehyclidine hydrochloride group ( group P) and conlrol group (group C). Palienls in group P were injecled with PHC 0.05 mg/kg 10 min before operalion. Palienls in group C were injecled with ihe same volume of saline. Venous blood was drawn al 5 lime poinls: 10 min before operalion ( T1 ) , immediately after operalion ( T2 ) , 8 h afler operalion( T3 ) , 24 h afler operalion( T4 ) , and 48 h afler operalion( T5 ) . The density of blood cylokine levels (IL - 6,IL - 10,TNF - α.) was delecled by enzyme - linked immunosorbenl assay. Blood samples were taken for analysis of serum glucose and laclale concenlralion al each lime point. Results There was no significant difference in the concenlralion of blood glucose, laclale and IL - 6,IL - 10,TNF - α between group P and group C al T, (P >0. 05) . In group P, the concenlralion of blood glucose and laclale was significantly lower al T2-5 than in group C (P <0. 05) . In group P, the concenlralion of IL - 6 and TNF - α. Was significantly lower al T2 _5 than that in group C ( P < 0. 05 ) . There was no significant difference in the concenlralion of blood IL - 10 belween the lwo groups ( P > 0. 05 ) . Conclusions 0. 05 mg/kg penehyclidine hydrochloride preconditioning before operalion can alleviate inflammalory and stress reaclion by regulating the nervous system, endocrine syslem and immunity syslem.%目的 观察盐酸戊乙奎醚对严重烧伤患者早期切痂植皮术后炎性及应激反应的影响.方法 40例拟行切痂植皮术患者,随机分为盐酸戊乙奎醚(P组)和对照组(C组)各20例.P组术前10 min静脉注射盐酸戊乙奎醚 0.05 mg/kg,对照组给予等容量生理盐水.分别于给药前(T1)、术毕(T2)、术后8 h(T3)、24 h(T4)、48 h(T5)采取静脉血标本,测定血浆白细胞介素-6(IL-6)、白细胞介素-10(IL-10)和肿瘤坏死因子-α (TNF-α)水平,并进行乳酸和血糖监测.结果 T1时点两组患者血糖、乳酸浓度和IL-6、IL-10、TNF-α水平的差异均无统计学意义(P>0.05);P组术后各时点血糖、乳酸浓度和IL-6、TNF-α水平均较C组显著降低(P＜0.05＝,而P组IL-10水平在术后各时点与C组的差异无统计学意义(P>0.05).结论 预先给予盐酸戊乙奎醚0.05 mg/kg可减轻严重烧伤患者早期切痂植皮术后的炎性及应激反应.