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目的探讨高原高寒环境下平战时猪枪弹伤后血浆中肿瘤坏死因子α(TNFα)、白介素-1b(IL-1b)、白介素-4(IL-4)、白介素-10(IL-10)、一氧化氮(NO)等炎症介质和内毒素含量变化的规律。方法将实验小型猪24头随机分为高原战时致伤组(GZ)、高原平时致伤组(GP)和平原平时致伤组(PP)。每组8头,在模拟战时和平时环境下致伤,分别于伤前、伤后10、30分钟、2、6、12小时、1、2、3、5、7和10天采集静脉血用Elisa法测定血浆TNFα、IL-1b、IL-4、IL-10浓度,用比色法测NO,用鲎试剂法测内毒素含量。结果 PP组在伤后2小时TNFα和IL-1b含量升高,NO在伤后6～12小时降低;IL-4和IL-10升高的时间较TNFα、IL-1b晚。(2)GP组TNFα、IL-1b、IL-4、IL-10和NO变化规律与PP组相似,但其升高或者降低的幅度较PP组要大,恢复到正常水平的时间较PP组延后。(3)GZ组伤前血浆中就出现TNFα、IL-1b和IL-4、IL-10轻度升高,伤后其升高的幅度较PP组和GP组大、达到高峰的时间较高原PP组提前,在高水平持续的时间较其它组长。结论高原环境条件下机体应激反应增强,当经受枪弹伤后,机体炎症反应强而持久,过度的炎症反应使机体的抵抗力下降,对感染的敏感性增加,易诱发脓毒血症的发生。
Objective To investigate the changes of plasma levels of tumor necrosis factor α (TNFα), interleukin-1b (IL-1b), interleukin-4 (IL-4) and interleukin-10 (IL-10) Nitric oxide (NO) and other inflammatory mediators and endotoxin content changes. Methods Twenty-four experimental miniature pigs were randomly divided into three groups: GZ, GP and PL. Eight in each group were wounded during simulated wartime and normal conditions, venous blood was collected before injury, 10,30 minutes after injury, 2,6,12 hours, 1,2,3,5,7 and 10 days respectively Plasma concentrations of TNFα, IL-1b, IL-4 and IL-10 were measured by Elisa method. Endotoxin was measured by colorimetric method and endotoxin content by spectrophotometry. Results The level of TNFα and IL-1b in PP group increased 2 hours after injury and the NO level decreased from 6 to 12 hours after injury. IL-4 and IL-10 increased later than TNFα and IL-1b. (2) The changes of TNFα, IL-1b, IL-4, IL-10 and NO in GP group were similar to those in PP group, but their amplitudes of increase and decrease were higher than those in PP group, and returned to the normal level Delay. (3) TNFα, IL-1b and IL-4 appeared in plasma before injury in GZ group, while IL-10 increased slightly in GZ group. Compared with those in PP group and GP group, the amplitude of IL-10 in GZ group was higher than that in PP group and GP group The PP group advanced earlier than the other leaders at a high level. CONCLUSIONS: The body’s stress response is enhanced under high altitude conditions. When subjected to bullet wounds, the body’s inflammatory response is strong and persistent. Excessive inflammation reduces the body’s resistance and increases the susceptibility to infection. It is easy to induce the occurrence of sepsis .