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目的观察烫伤后早期大鼠结肠平滑肌细胞骨架(CSL)含量及形态学的改变,初步探讨烧伤后胃肠动力障碍的发生机制及其临床意义。方法将70只成年健康Wistar大鼠随机分为正常对照组(10只,不烫伤);烫伤组(60只,于背部造成10 cm×7 cm的深Ⅱ度创面)。烫伤组大鼠于伤后1、3、6、12、24、48 h处死,另处死正常对照组大鼠,取结肠起始段组织,分作2份,一份于透射电镜下观察CSL的形态学变化;一份经急性酶分离法获得平滑肌细胞悬液,加入异硫氰酸荧光素标记的抗大鼠肠道平滑肌CSL微丝肌动蛋白抗体,采用流式细胞仪检测荧光强度以反映平滑肌细胞内CSL含量的变化。结果透射电镜显示:烫伤组大鼠伤后1-3 h结肠平滑肌细胞内丝状纤维分布混乱、稀疏,密斑分布不均,6-12 h CSL形态、分布等逐步趋于平稳,24 h则逐步恢复正常,48 h时与正常对照组相似。烫伤组大鼠肠道平滑肌CSL含量于伤后1 h明显升高(610±23),此后逐渐降低, 3 h已明显低于正常对照组(92±17),约12 h开始逐渐回升,24 h已超过正常对照组,且呈上升趋势持续至48 h,组间比较差异有统计学意义(P<0．05或0．01)。结论烫伤后早期可出现明显的肠道平滑肌CSL含量及形态学的改变,此过程体现了机体的修复与损伤力量抗衡的动态变化。此外,肠道平滑肌CSL含量的变化可能是导致伤后其细胞动力功能出现异常、肠道功能紊乱、肠壁结构受损的重要机制之一。
Objective To observe the content and morphological changes of colon smooth muscle cells (CSL) in rats after scald and to investigate the possible mechanism and clinical significance of gastrointestinal motility disorders after burn injury. Methods Seventy healthy adult Wistar rats were randomly divided into normal control group (n = 10) and burn group (n = 60). Rats in the scald group were sacrificed at 1, 3, 6, 12, 24, and 48 h after injury. Another group of rats in the normal control group were sacrificed. The initial part of the colon was divided into two groups. One was observed under transmission electron microscope Morphological changes; one by acute enzymatic separation obtained smooth muscle cell suspension, adding fluorescein isothiocyanate-labeled anti-rat intestinal smooth muscle CSL actin actin antibody, using flow cytometry to detect fluorescence intensity to reflect Changes of CSL content in smooth muscle cells. Results Transmission electron microscopy showed that the distribution of filamentous fibers in the scald rats was disarranged, sparsely distributed and unevenly distributed in the smooth muscle cells within 1-3 hours after injury, and the morphology and distribution of CSL gradually became stable after 6-12 h. Gradually returned to normal, similar to the normal control group at 48 h. The contents of CSL in intestinal smooth muscle in scalded group increased significantly at 1 h after injury (610 ± 23), then gradually decreased at 3 h, which was significantly lower than that in normal control group (92 ± 17) h had surpassed the normal control group, and the upward trend persisted to 48 h, the difference between the two groups was statistically significant (P <0.05 or 0.01). Conclusion The CSL content and morphological changes of intestinal smooth muscle may appear in the early stage of scald. This process reflects the dynamic changes of the balance between the body repair and the damage power. In addition, the change of CSL content of intestinal smooth muscle may be one of the important mechanisms that lead to abnormal cell motility function, intestinal dysfunction and damaged intestinal wall structure after injury.