目的 观察盐酸戊乙奎醚对严重烧伤患者早期切痂植皮术后炎性及应激反应的影响。方法40例拟行切痂植皮术患者，随机分为盐酸戊乙奎醚（P组）和对照组（C组）各20例。P组术前10 min静脉注射盐酸戊乙奎醚 0.05 mg/kg，对照组给予等容量生理盐水。分别于给药前(T1)、术毕（T2）、术后8 h(T3)、24 h(T4)、48 h(T5)采取静脉血标本，测定血浆白细胞介素-6(IL-6)、白细胞介素-10(IL-10)和肿瘤坏死因子-α (TNF-α)水平，并进行乳酸和血糖监测。结果T1时点两组患者血糖、乳酸浓度和IL-6、IL-10、TNF-α水平的差异均无统计学意义(P>0.05)；P组术后各时点血糖、乳酸浓度和IL-6、TNF-α水平均较C组显著降低(P＜0.05），而P组IL-10水平在术后各时点与C组的差异无统计学意义(P>0.05)。结论预先给予盐酸戊乙奎醚0.05 mg/kg可减轻严重烧伤患者早期切痂植皮术后的炎性及应激反应。

Objective To study the effect of penehyclidine hydrochloride (PHC) on inflammatory and stress reaction in severe burn patients undergoing early escharectomy and skin grafting. MethodsForty severe burn patients undergoing early escharoctomy and skin graft were randomly divided into two groups of 20 each: penehyclidine hydrochloride group (group P) and control group (group C). Patients in group P were injected with PHC 0.05 mg/kg 10 min before operation. Patients in group C were injected with the same volume of saline. Venous blood was drawn at 5 time points: 10 min before operation (T1), immediately after operation (T2), 8 h after operation(T3), 24 h after operation(T4), and 48 h after operation(T5).The density of blood cytokine levels (IL-6，IL-10，TNF-α) was detected by enzyme-linked immunosorbent assay. Blood samples were taken for analysis of serum glucose and lactate concentration at each time point.ResultsThere was no significant difference in the concentration of blood glucose, lactate and IL-6，IL-10，TNF-α between group P and group C at T1 (P>0.05). In group P, the concentration of blood glucose and lactate was significantly lower at T2-5 than in group C (P＜0.05). In group P, the concentration of IL-6 and TNF-α was significantly lower at T2-5 than that in group C (P＜0.05). There was no significant difference in the concentration of blood IL-10 between the two groups (P>0.05). Conclusions0.05 mg/kg penehyclidine hydrochloride preconditioning before operation can alleviate inflammatory and stress reaction by regulating the nervous system, endocrine system and immunity system.