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目的:探讨严重创伤后全血硒(Se)含量及其相关酶谷甘胱肽过氧化物酶(GPx)和氧化应激产物丙二醛(MDA)的变化规律及与MOF发生的相关情况。方法:建立严重创伤家兔模(ISS=22分),检测伤后12小时、36小时、60小时、6天、9天、14天、21天全血Se含量、GPx活性、血清UDA含量。结果:伤后5天血Se含量1.48ug/ml-0.54ug/ml,较正常组2.65ug/ml-0.64ug /ml明显下降(P<0.001),伤后7天-14天为1.98±0.23ug/ml仍明显低于正常(P<0.01),3周迭2.21ug/ml-0.361ug/ml呈恢复趋势(P>0.05)。伤后12小时-7天血GPx活性2.52U/ul.min-0.59U/ul.min较正常3.58U/ul.min-0.89U/ul.min下降非常显著(P<0.001);7天后趋于正常3.26-0.44(P>0.05)。伤后3天血清MDA始升高,6天达高峰4.59nmol/ml-0.38nmol/ml,较正常的2.05-0.28升高非常显著(P<0.001),9天后维持于2.52nmol/ml-0.68nmol/ml。严重创伤组家兔有7只死亡(死亡率35%),病理学检查符合MOF表现。结论:严重创伤可引发血Se及其相关酶活性急性显著降低,相应的氧化应激产物量增高,提示这种急性微量元素缺乏可能与继发多器官衰竭(MOF)和高死亡率有关。
Objective: To investigate the changes of selenium (Se) content, the content of glutathione peroxidase (GPx) and the malondialdehyde (MDA) in serum of severely traumatic patients and the correlation with the occurrence of MOF. Methods: Severe trauma rabbit model (ISS = 22) was established. Se content, GPx activity and serum UDA content of whole blood were detected at 12h, 36h, 60h, 6d, 9d, 14d and 21d after injury. Results: The blood Se level was 1.48ug / ml-0.54ug / ml 5 days after injury, significantly decreased from 2.65ug / ml to 0.64ug / ml in normal group (P <0.001) and 1.98 ± 0.23 ug / ml was still significantly lower than the normal (P <0.01), 3 weeks Diego 2.21ug / ml-0.361ug / ml showed a trend of recovery (P> 0.05). The GPx activity 2.52U / ul.min-0.59U / ul.min was significantly lower than the normal 3.58U / ul.min-0.89U / ul.min at 12h-7d after injury (P <0.001) At normal 3.26-0.44 (P> 0.05). Serum MDA began to rise 3 days after injury and peaked at 4.59nmol / ml-0.38nmol / ml in 6 days, which was significantly higher than that of normal 2.05-0.28 (P <0.001) and remained at 2.52nmol / ml-0.68 after 9 days nmol / ml. Severe trauma group of rabbits, 7 deaths (35% mortality), pathological examination consistent with MOF performance. CONCLUSIONS: Severe trauma can lead to an acute and significant decrease in serum Se and its related enzymes, with corresponding increases in the amount of oxidative stress products, suggesting that this lack of acute micronutrients may be associated with secondary multiple organ failure (MOF) and high mortality.