|
Objective: In this study, through the establishment of the pig abdomen intestinal firearm wound model, observed changes in cardiac structure and function after injury, after injury, plasma levels of endotoxin, the heart of NF-κB and iNOS expression, myocardial apoptosis dynamic changes to explore the heart of iNOS secondary heart injury after intestinal firearm wound in the abdomen and other cytokines aimed to provide theoretical and experimental evidence for the prevention and treatment of abdominal gunshot wound in the heart of the secondary injury. Methods: 42 healthy Landrace pigs, were randomly divided into 7 groups: control group and to abdominal firearm hour after injury, 2h, 4h, 8h, 12h and 24h experimental group. The lower edge of the experimental group under normal temperature and humidity environment (temperature 22 ℃ -24 ° C, relative humidity of 50% -60%) after anesthesia military 54 pistol shooting injury (shooting point to the rear of the umbilical level 2cm at the right side of the abdominal wall folds hairless District), the establishment of intestinal firearm wound model. Control group, in addition to not injured, and the remaining steps are the same as the experimental group. Each experimental group at the corresponding time points after injury drawn back to the lab immediately drawn to the control group. In the light microscope observation the groups heart histological changes, simultaneous determination of serum LDH, CK, CK-MB level; endotoxin levels in plasma using a chromogenic substrate Limulus test detected; using the Tunnel assay apoptosis index; immunohistochemical image analysis method for the determination of the myocardial tissue NF-κB, iNOS expression. Results: (1) heart looks normal, light the microscope control group and 1h, 2h group myocardial cells arranged in neat rows, cell staining. Arterial and venous endothelial integrity; including 1h, 2h myocardial capillary congestion. 4h, 8h, 12h, 24h myocardial progressive increase muscle bundle gap widened myocardial cell edema, eosinophilic change. (2) the experimental group serum LDH, CK, CK-MB water were significantly higher than that in the control group (P lt; 0.01), overall analysis 1h, 2h group of cardiac index rose faster rate; 4h, 8h, 12h each indicators rising rate slows down, but overall continued to show a gradual upward trend; 24h each index increased again quickly. (3) experimental group plasma endotoxin average significantly higher (P lt; 0.05), peak after injury 8h, 12h after injury remained at peak levels. (4) NF-κB expression of myocardial tissue injury were significantly higher (P lt; 0.01); rapid rise of the NF-κB expression in 2h, 4h, 2h, 1h were group compared to P lt; 0.01; injury 8h to 12h of NF-κB to rise steadily (P lt; 0.05); injury the 24h group of NF-κB (P lt; 0.01) again fast rise and reached a peak value. (5) myocardial tissue iNOS expression after injury were significantly higher than that in the control group (P lt; 0.01); rapid increase in the expression of iNOS in 2h; injury after 4h and 8h, 12h iNOS expression to rise steadily, but its IOD values ??were higher than the previous group (P lt; 0.05); fast rise again 24h group iNOS after injury (P lt; 0.01), reached a peak value. (6) 2h after injury apoptotic cells have increased drastically; 2h to 8h apoptotic cells still showed an increasing trend, but the increase is less 4h group compared with 8h number of apoptotic cells was not statistically significant; 12h group 24h group increased the number of apoptotic cells to increase again. (7) The correlation analysis showed that abdominal gunshot wound in the pig heart after iNOS expression levels of serum LDH, CK and CK-MB levels, NF-κB expression and apoptosis of myocardial cells, plasma endotoxin levels were positively correlated, with correlation coefficients NF-κB expression 0.986,0.994,0.984,0.980,0.935,0.778 (, P lt; 0.01); heart level and serum LDH, CK, CK-MB levels, myocardial apoptosis, plasma endotoxin levels showed a positive correlation , the correlation coefficients were 0.968,0.971,0.957,0.941,0.790, (P lt; 0.01). Conclusions: (1) to abdominal firearm injuries result in traumatic changes in cardiac structure and function, along with the extension of time after the injury aggravated. (2) abdominal gunshot wound in myocardial tissue can induce NF-κB, iNOS expression mediated cardiac injury. Complex trauma the endotoxin - cytokine network plays an important role in the occurrence and development of secondary cardiac injury in promoting intestinal firearm wound.
|