| Purpose:Multiple organ dysfunction syndrome(MODS)is one of the most common complications of severe burns(scalds)due to its high late mortality and difficult treatment.Inflammation due to traumatic infection、oxidative stress、hyperlacticemia and impaired glucose tolerance play an important role in the development of MODS.To confirm the effect of GIK and Sodium Pyruvatein the treatment of Severe Scalded MODS rat model,the inflammation indexes of LPS,sTREM-1 and HMGB-1,the oxidative stress indexes of MDA and SOD and the impaired glucose toleranceindexes of GLU,LA,LA/PA,etc.were observed in the treatment of GIK and Sodium Pyruvate alone or in combination therapy.The combination therapy of GIK and Sodium Pyruvate was established as an important measure to prevent and treat MODS in severe burns(scalds),which provided laboratory basis.Experimental scheme:1)Making animal models: Preparing severely scalded MODS rats.Eighty adult SD rats were selected and scalded with III degree of back skin after anesthesia,then endotoxin was injected intraperitoneally.2)Grouping animal models: Severe scalded MODS rats were randomly divided into four groups: GIK group,SP group,combination therapy group(GIK + SP)and control group.3)Collecting specimens: The levels of ALT,CRE and CK being measured before and 1,3,5 and 7 days after burn in four groups of rats,which confirmed the MODS models of burn were established successfully.4)Detecting of experimental data:1)Survival rates of rats in four groups were observed and recorded at 1,3,5 and 7 days.2)The inflammation indexes of LPS,sTREM-1 and HMGB-1,the oxidative stress indexes of MDA and SOD and the impaired glucose toleranceindexes of GLU,LA,LA/PA,etc.were measured before and 1,3,5 and 7 days after injury in four groups of rats.5)Analyzing experimental results:Statistical software SPSS11.0 was used to analyze experimental data.The survival rate,fasting GLU,plasma LPS,sTREM-1,HMGB-1,MDA,SOD,LA and LA/PA data of rats in each group were compared with P < 0.05.Experimental result:1)The levels of GLU,ALT,CRE,CK,etc.indexes in the control group at 1,3,5 and 7 days after injury being significantly higher than those before injury(P<0.01),which suggested that the models of the experimental rats with high liver function,renal dysfunction,cardiac insufficiency and multiple organ dysfunction syndrome was successfully established.2)The levels of LPS,sTREM-1,HMGB-1,MDA,GLU,LA and LA/PA indexes in the control group at 1,3,5 and 7 days after injury were significantly higher than those before injury(P<0.01),and the levels of SOD were significantly lower than those before injury(P<0.01).Severe scalded MODS rats have symptoms of inflammation due to overinfection,oxidative stress,hyperlacticemia and impaired glucose tolerance.3)The levels of GLU indexes of GIK group and GIK + SP group were significantly higher than those of control group at 1,3,5 and 7 days after injury(P<0.01),but there was no significant change in SP group and control group(P>0.05).GIK had the effect of controlling hyperglycemia,but Sodium Pyruvate had no significant effect on controlling hyperglycemia(P>0.05).4)The levels of LPS,sTREM-1,HMGB-1,MDA,LA and LA/PA indexes in GIK group,SP group and GIK+SP group were significantly lower than those in control group at 1,3,5 and 7 days after injury(P<0.01),and the levels of SOD in GIK+SP group were significantly higher than those in GIK group and SP group(P<0.01),and the levels of SOD in GIK+SP group were significantly higher than those in GIK group and SP group alone(P<0.01).Both GIK and Sodium Pyruvate have the effects of inflammation,anti-oxidative stress,correction of hyperlacticemia and impaired glucose toleranceand so on and the effect of combination therapy of GIK and Sodium Pyruvate is better than that of single therapy.5)ALT,CRE and CK in blood of rats in GIK group,SP group and GIK + SP group at different time points after injury were significantly lower than those in control group(P<0.01),and the rats in GIK + SP group were significantly lower than those in GIK group and SP group alone(P<0.01).Both GIK and Sodium Pyruvate have protective effects on liver,renal dysfunction and cardiac insufficiency of severely scalded MODS rats and the effect of combination therapy of GIK and Sodium Pyruvate is better than that of single therapy.6)Although the 7-day mortality of GIK,SP and GIK+SP groups was lower than that of control group,there was no significant difference(P>0.05).Conclusion:1)Severe scalded MODS rats are involved in inflammation and oxidative stress,hyperlacticemia and impaired glucose tolerance.2)Sodium Pyruvate can not effectively reduce hyperglycemia in severely scalded MODS rats,but it can effectively reduce the levels of impaired glucose tolerance such as hyperlacticemia and LA/PA ratio.3)That both GIK and Sodium Pyruvate can reduce the levels of inflammation,oxidative stress,hyperlacticemia and impaired glucose tolerance in severely scalded MODS rats,suggested that both GIK and Sodium Pyruvatecan be used as effective measures to prevent and treat MODS after severe trauma.4)That the combination therapy of GIK and Sodium Pyruvatecan reduce the levels of inflammation and oxidative stress,hyperlacticemia and impaired glucose tolerance in severely scalded MODS rats,which is superior to the treatment of GIK and Sodium Pyruvate alone,suggested that the combination of GIK and Sodium Pyruvateis more effective in the prevention and treatment of severely scalded MODS.5)Severe scalded MODS rats involve liver,renal dysfunction and cardiac insufficiency.GIK and Sodium Pyruvatehave protective effects on liver,kidney and myocardium of severely scalded MODS rats,and the combination therapy of GIK and Sodium Pyruvateis better than that of single therapy. |
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