摘要
目的探讨导致烧伤后血浆内毒素水平升高和肠源性脓毒症的肠道免疫学因素．方法采用４０％体表面积（ＴＢＳＡ）Ⅲ度烫伤大鼠模型（ｎ＝４０），对肠道内ＩｇＡ含量、肠道细菌ＩｇＡ包被率和血浆内毒素的变化进行动态观察．结果伤后血浆内毒素水平（ｋＥＵ／Ｌ）明显升高，伤后３ｄ达０１１３±００３９，（对照组，ｎ＝１０，００８３±０００７，Ｐ＜００５）；肠内容物中ＩｇＡ含量（μｇ／ｇ）逐渐下降，伤后１ｄ，３ｄ均明显降低，其中３ｄ达３４１５±４０２（对照组为５６２９±１７２０，Ｐ＜００１），为最低点；而后逐渐回升，至伤后１０ｄ已接近对照组水平．烫伤后各时相点肠道细菌的ＩｇＡ包被率均明显降低，伤后３ｄ降至４４３％±６５％（对照组为６３９％±６５％，Ｐ＜００１）．结论烧伤后肠道内ＩｇＡ含量与功能的异常可能是导致内毒素血症和肠源性脓毒症的重要原因之一．
AbstractAIM To investigate the intestinal immunological factor associated with development of endotoxiemia and gutderived sepsis after burns.METHODS The level of IgA in intestinal content, the coat rate of intestinal bacteria by IgA and endotoxin level were measured in rats (n=40) after 40% total body surface area (TBSA) fullthickness scald injury.RESULTS The IgA level in intestinal content and coat rate of intestinal bacteria by IgA(%) were significantly lower (341.5μg/g±40.2μg/g and 44.3%±6.5%) than that in control group (n=10) (562.9μg/g±172.0μg/g and 63.9%±6.5%, both P<0.01), and the endotoxin levels in plasma were significantly higher (0.113kEU/L±0.039kEU/L) than that in control group (0.083kEU/L±0.007kEU/L, P<0.05) on day 3 following scald injury.CONCLUSION The changes in level and function of IgA may play an important role in the development of endotoxemia and gut-derived sepsis after major burns.
