BACTERIAL TRANSLOCATION AFTER BURN INJURY - THE CONTRIBUTION OF ISCHEMIA AND PERMEABILITY CHANGES
BACTERIAL TRANSLOCATION AFTER BURN INJURY - THE CONTRIBUTION OF ISCHEMIA AND PERMEABILITY CHANGES
复制标题
DOI：
10.1097/00024382-199404000-00007
复制
发表时间：
1994-04-01
期刊：
影响因子：
3.1
通讯作者：
WALKER, PB
中科院分区：
文献类型：
--
作者：
HORTON, JW;WALKER, PB
细菌易位(Bt)已被证明发生在应激和创伤中。在这项研究中，我们研究了烧伤后肠道通透性改变(用铬-51-EDTA测量)和肠道血流量(放射性微球)在肠屏障功能丧失中的作用。SD大鼠烫伤面积为42.6+/-0.6%，对照组为假烧伤动物。伤后24 h处死29只大鼠和20只假烧伤大鼠，取肠系膜结节(MLN)、盲肠、脾和肝脏进行培养。烧伤组BT的发生率显著高于假手术组(MLN，55比15%；脾，31比10%；肝脏，31比10%；P<；0.05)。所有大鼠盲肠中革兰氏阴性菌的浓度相似(5.2+/-0.2×10(8)个菌落形成单位/g)。烧伤后5h，肠血流量(1.60±0.20)较假手术组(2.49±0.24)ml/min/g显著降低(P=0.01)，此时血浆-51-EDTA的血浆-管腔清除率(0.146+/-0.033，N=9)高于假手术组(0.050+/-0.010 ml/min/100g，N=9，P=0.01)；伤后24 h，假手术组(2.86±0.46，N=10)和烧伤大鼠(2.29±0.44 ml/min/g，N=11)的肠道血流量无显著差异，血浆-51-EDTA对肠腔的清除率与假手术组(0.054±.010，N=11)和烧伤大鼠(0.051+/-.006 ml/min/100g，N=12)相似。这些数据证实，在严重的皮肤烧伤后，肠道固有的细菌可以从肠道转移到全身器官；肠道屏障功能的丧失与烧伤后一过性肠道灌流不足和肠道通透性增加有关。
Bacterial translocation (BT) has been shown to occur in stress and trauma. In this study, we examined the contribution of altered intestinal permeability (measured with Cr-51-EDTA) and intestinal blood flow (radioactive microspheres) to the loss of intestinal barrier function after burn injury. A 42.6 +/- 0.6% total body surface area scald burn was produced in Sprague-Dawley rats; sham burn animals served as controls. Rats (29 burn and 20 sham burn) were sacrificed 24 h postburn, and mesenteric nodes (MLN), cecum, spleen, and liver were cultured. The incidence of BT was significantly higher in burn compared to shams (MLN, 55 vs. 15%; spleen, 31 vs. 10%; liver, 31 vs. 10%; p < .05). Cecal concentration of Gram-negative bacteria were similar in all rats (5.2 +/- 0.2 X 10(8) colony forming units/g). 5 h postburn, intestinal blood flow decreased significantly in burn (1.60 +/- .20) compared to shams (2.49 +/- .24 ml/min/g, p = .01); at this time, plasma to luminal clearance of Cr-51-EDTA was greater in the burn (.146 +/- .033, N = 9) than in shams (.050 +/- .010 ml/min/100 g, N = 9, p = .001); 24 h postburn, there was no significant difference in intestinal blood flow in sham (2.86 +/- .46, N = 10) and burn rats (2.29 +/- .44 ml/min/g, N = 11); plasma to intestinal lumen clearance of Cr-51-EDTA was similar in sham (.054 +/- .010, N = 11) and burn rats (.051 +/- .006 ml/min/100 g, N = 12) 24 h postburn. These data confirm that after a major cutaneous burn, bacteria indigenous to the gut can translocate out of the intestine to systemic organs; loss of gut barrier function is related to transient intestinal hypoperfusion and increased intestinal permeability after burn injury.