法医学杂志

法医学杂志 ›› 2011, Vol. 27 ›› Issue (3): 169-173.DOI: 10.3969/j.issn.1004-5619.2011.03.003

• 论著 • 上一篇    下一篇

创伤后多器官衰竭机体铁及铁蛋白的含量变化

王  典1，杨天潼1，2，于  文3，于晓军1，王海鹏1，4，王广欢1   

  1. （1. 汕头大学 医学院法医学教研室，广东 汕头 515041； 2. 中国政法大学 证据科学研究院，北京 100040； 3. 吉林市公安局 交通管理支队，吉林 吉林 132001； 4. 北华大学 医学院法医学教研室，吉林 吉林 132001）
  • 发布日期:2011-06-25 出版日期:2011-06-28
  • 通讯作者: 通信作者：于晓军，男，主任法医师，教授，博士研究生导师，主要从事法医学教学、科研及鉴定工作；E－mail：xjyu@stu.edu.cn
  • 作者简介:王典（1978—），男，广东河源人，博士，助理研究员；E－mail：g_dwang@stu.edu.cn
  • 基金资助:

    国家自然科学基金资助项目（30772458、81072508）

Iron and Ferritin Changes in Multiple Organs Failure after Trauma

WANG DIAN1, YANG TIAN-TONG1,2, YU WEN3, YU XIAO-JUN1, WANG HAI-PENG1,4, WANG GUANG-HUAN1   

  1. （1. Department of Forensic Science, Medical College, Shantou University, Shantou 515041, China; 2. Research Institute of Evidence Science, China University of Political Science and Law, Beijing 100040, China; 3. Jilin Traffic Management Division, Public Security Bureau of Jilin, Jilin 132001, China; 4. Department of Forensic Medicine, Medical College of Beihua University, Jilin 132001, China）
  • Online:2011-06-25 Published:2011-06-28

摘要： 目的 观察家兔不同程度创伤后血清及肝组织中铁、血清中铁蛋白含量和髓过氧化物酶（myeloperoxidase，MPO）阳性粒细胞计数的变化，分析其与继发多器官功能衰竭（multiple organ failure，MOF）的关系。 方法 建立家兔创伤模型，检测伤后各时间点血清及肝组织中铁、血清铁蛋白含量，并进行外周血MPO阳性粒细胞计数。 结果 血清铁含量于伤后12~36 h急剧下降，轻伤组60 h后逐渐增加至恢复正常，重伤及死亡组60 h后持续低水平；死亡组肝组织铁含量显著升高。轻伤组血清铁蛋白含量改变不明显，重伤及死亡组血清铁蛋白含量呈早期轻度升高、后期显著下降的趋势。MPO阳性粒细胞计数于伤后早期升高，轻伤组6 d后开始降低并逐渐恢复正常，重伤及死亡组6 d后持续明显低于正常水平。部分家兔重伤后60 h～6 d死亡，其器官组织病理变化符合MOF改变。 结论 创伤可引发血清铁和铁蛋白含量及MPO阳性粒细胞计数与损伤程度相关的改变，重伤导致的铁及其相关蛋白等失代偿性改变可能是继发MOF及死亡的机制之一。

关键词: 法医病理学, 创伤和损伤, 铁, 铁蛋白质类, 多器官功能衰竭, 兔

Abstract: Objective To investigate the changes of iron content in serum and liver, ferritin content in serum, percentage of myeloperoxidase（MPO） positive granulocyte in rabbits after different serious trauma and to explore the relationship between these changes and multiple organ failure（MOF）. Methods Rabbit trauma models were established. Iron content in serum and liver, ferritin content in serum and the percentage of MPO positive granulocyte were measured at different time after trauma. Results After trauma, iron content in serum decreased sharply in early period （12-36 h） and increased gradually to normal level in mild traumatic group after 60 h. Iron content in serum remained lower level in severe traumatic and death group 60 h after trauma. Iron content in liver obviously increased in death group. The changes of ferritin content in serum in mild traumatic were not obvious. Ferritin contents in serum in severe injury group and death group were slightly higher in early period and decreased in later period. The percentage of MPO positive granulocyte increased in early period after trauma. The percentage began to decrease 6 d after trauma and returned to normal level in mild traumatic group. The percentage obviously was significantly lower than normal levels in severe traumatic group and death group 6 d after trauma. Some rabbits died 60 h-6 d after severe trauma, and the pathological changes in the other organs were consistent with MOF. Conclusion Trauma can cause the serum iron, ferritin levels and percentage of MPO positive granulocyte changes. Severe trauma can cause uncompensated changes of these indicators, which could be the main mechanisms of MOF and death.

Key words: forensic pathology, wounds and injuries, iron, ferritins, multiple organ failure, rabbits

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