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目的:研究重度创伤时机体锌含量及其相关抗氧化功能的影响,及其引发的急性锌缺乏与多器官功能衰竭和死亡 率的关系。方法:建立兔轻伤(ISS=13)和重伤(ISS=22)模型,检测伤前及伤后12h,60h,6d,9d,14d,28d血清及肝Zn 含量、Cu／Zn-SOD活性及肝MT含量。结果:轻伤后1d-6d血Zn值17.23 umol/L±1.48 umol／L,与伤前23.8 umol／L±15.08umol/L 比较下降显著,P<0.05。重伤后1d-28d血Zn含量下降明显。其中1d-14d为7.87 umol／L±2.92 umol／L,P<0.01,28d为12.14 umol／L ±9.46umol／L,P<0.05。重伤组中死亡率为35％,死亡动物血Zn水平比未死动物伤后1d下降显著,P<0.05。重伤组肝Zn含量 伤后上升,血清Cu／Zn-SOD活性持续两周高于伤前,P<0.05,肝Cu／Zn-SOD及MT水平均呈先升后降趋势。结论:重伤后体内 存在急性TE缺乏及其引发的一系列失代偿性功能代谢变化,可能为重度创伤合并院内感染或多器官衰竭,甚至死亡的重要因素 之一。
OBJECTIVE: To study the effect of zinc on the level of zinc and its antioxidant activity in patients with severe trauma and the relationship between acute zinc deficiency and multiple organ failure and mortality. Methods: Serum and liver Zn contents, Cu / Zn-SOD activities and the activity of Cu / Zn-SOD in pre-injury and post-injury 12h, 60h, 6d, 9d, 14d and 28d were detected by ISS = 13 and ISS = Liver MT content. Results: After 1 d-6 d, the Zn value of blood was 17.23 umol / L ± 1.48 umol / L, which decreased significantly compared with 23.8 umol / L ± 15.08 umol / L before injury (P <0.05). After 1d-28d severely injured blood Zn levels decreased significantly. Among them, 1d-14d was 7.87 umol / L ± 2.92 umol / L, P <0.01,28d was 12.14 umol / L ± 9.46umol / L, P <0.05. Mortality in the severely injured group was 35%, and the level of blood Zn in the dead animal was significantly lower than that of the uninjured one day after injury (P <0.05). The content of Zn in liver of injured group increased after injury, the activity of Cu / Zn-SOD in serum increased two weeks later than that before injury, P <0.05, and the levels of Cu / Zn-SOD and MT in liver increased first and then decreased. Conclusion: There is acute TE deficiency and a series of decompensated functional metabolic changes in severely injured body, which may be one of the important factors of severe trauma with nosocomial infection or multiple organ failure and even death.