严重烧伤患者常因锌的大量丢失而造成锌营养不良,而补锌却未成为临床治疗的一个环节,其主要原因在于担心补锌可能造成锌的蓄积毒性或干扰其它相关元素的代谢.为此,笔者通过给烫伤大鼠进行不同剂量补锌,观察其对各主要脏器的锌及部分二价元素代谢的影响.

烧伤创面始终是烧伤治疗的焦点,创面愈合一直是烧伤治疗的目标.影响创面愈合的诸多因素己被普遍关注,但有关微量元素锌与创面愈合的关系论述欠丰.近年来大量研究证实,严重烧伤后普遍缺锌,除对整体产生不良影响外,还使创面愈合延迟.补锌确有改善锌营养状态,促进创面修复之功效. 解放军第三0四医院烧伤研究所北京,100037

Objective To study the condition of zinc deficiency in burned animal and its influence on wound healing after zinc supplementation in different dosage and access. Methods 80 Wistar rats were scalded by boiling water and 15% TBSA deep second degree burn was produced.They were divided into normal control group,supply zinc throught diet group and through wound surface group.The rats were fed with diets containing normal amount of zinc (40mg/kg,N group),higher zinc content (80mg/kg,H group) and normal zinc content together with smearing AgZn salfadiazine cream (761mg/kg W group)respectively.The rats were killed on 1,3,7days postburn.The serum zinc and growth hormone (GH),wound zinc and hydroxyproline (OHP) were measured.Two additional groups were used as control by smearing either AgZn SD cream or iodophor on wound to observe wound healing. Results The levels of serum zinc,wound zinc and OHP decreased markedly and serum GH increased on first postburn day (PBD).The level of serum zinc,wound zinc and serum GH increased quickly with higher zinc diet supplementation.When zinc was supplemented through burned wound, wound zinc and OHP increased,contributing to wound repair acceleration.The wound of deep second degree healed on 12.3±2.1day in AgZn SD cream group,but 66.7% of wounds healed on 21 PBD in control group. Conclusions The levels of serum zinc,wound tissue zinc and OHP were lowered after burn injury and they could be elevated after supplementing zinc by diet or through wound.The serum zinc and GH level went up after diet supplementation.Also supplementing zinc through wound could contribute to an increase in wound zinc and OHP,promoting wound healing.

目的:严重烧伤后往往存在锌营养不良状态,本实验考察不同剂量补锌是否会造成锌的蓄积或影响铜代谢.方法:利用人工半合成饲料技术制成不同含锌饲料;大鼠进食低锌饲料成为缺锌模型,造成 20% TBSA深Ⅱ度烫伤后饲以不同含锌饲料(含锌量分别为: 1.6 μg/g; 24.7 μg/g; 286.9 μg/g),原子吸收法分析血清、肝、肾、脾和睾丸的锌、铜含量.同时设一组大鼠烫伤前后均进食正常含锌饲料(含锌量: 24.7 μg/g) 做对照组.结果:补锌可显著提高血清和各器官的含锌量,补高锌组未发现器官存在锌的过量蓄积;大剂量补锌使血清、肾脏铜含量也明显提高.结论:在严重烧伤后的锌缺乏状态下,短时期内适当加大补锌量不会导致锌的过量蓄积,对铜代谢无不良影响.

目的 观察补锌对缺锌大鼠烫伤后生长及营养状态的影响。 方法 1月龄大鼠进食低锌饲料 1周形成锌缺乏状态 ,造成 2 0 %TBSA深Ⅱ度烫伤后 ,分别改饲低锌、正常锌、高锌饲料。同时设大鼠烫伤前后均进食正常含锌饲料做对照组。用体重变化、累积氮平衡与空肠黏膜、肝、肾、脾、睾丸的DNA和蛋白质含量反映大鼠营养状况。 结果 补正常及高锌大鼠的体重、食物转化率、累积氮平衡和器官蛋白质含量均优于低锌大鼠 ,血清锌、血清碱性磷酸酶活性、空肠黏膜、肾、脾、睾丸的DNA含量在补锌后显著提高。 结论 补锌有助于烫伤后大鼠营养状况的改善 ,适当加大补锌剂量对提高肾与睾丸的DNA含量优于常量补锌

建国51年来伴随经济的发展和科学技术的进步,各医学专科也得到相应的发展和进步.烧伤专业虽起步较晚,于1958年方独立建科,但发展迅速,独具中国特色的烧伤治疗与研究已蜚声于国内外.

目的:严重烧伤往往造成睾丸的退行性病变,本实验考察补锌是否有利于睾丸营养状态、结构、内分泌功能与生精功能的恢复.方法:1月龄大鼠进食低锌饲料1周形成缺锌模型,造成20%TBSA深二度烫伤后饲以不同含锌量饲料(含锌量分别为:1.6μg/g、24.7μg/g、286.9μg/g),分析睾丸锌、铜、镁、钙、DNA、蛋白质、睾酮含量,观察睾丸病理改变.同时设一组大鼠烫伤前后均进食正常含锌饲料(含锌量:24.7μg/g)做对照组.结果:补锌使睾丸含锌量、DNA与睾酮含量显著提高;使睾丸湿重、蛋白质含量有所提高;缺锌时曲细精管呈幼稚状态,补锌后发育成熟,有精子产生.结论:补锌可显著改善睾丸营养状态,刺激内源性睾酮合成,促使睾丸恢复正常形态.