中文摘要：

目的观察创伤后应激反应情况、炎症活动性等指标,筛选出一种可能的指标,帮助降低创伤后发生迟发性心脏功能减退患者的临床漏诊率。方法利用Noble-Collip机械创伤仪制备机械创伤模型,通过离体心脏灌流技术检测大鼠离体心脏功能,ELISA方法检测机械创伤后0h、6h、12h、24h血清肾上腺素（NE）、超敏C反应蛋白（hs-CRP）和血管紧张素Ⅱ（AngⅡ）浓度的动态变化。结果与伪创伤组相比,机械创伤后24h大鼠离体心功能降低;创伤组创伤后24h内各时间点血清NE、hs-CRP和AngⅡ浓度均逐步增高;机械创伤后24h大鼠血清中AngⅡ浓度与＋dp/dtmax呈负相关（r=-0.574,P〈0.05）,肾上腺素浓度与左室＋dp/dtmax呈正相关（r=0.402,P〈0.05）,而hs-CRP浓度与＋dp/dtmax相关性不显著（P〉0.05）。结论循环AngⅡ的过度激活与机械性创伤导致心肌损伤或心功能下降密切相关,提示临床可以通过检测出血液中AngⅡ浓度来作为机械创伤发生心功能障碍的筛选指标。

英文摘要：

Objective To investigate the stress response and inflammation activity after mechanical trauma.Methods Traumatic rat models were established by Noble-Collip drum.Cardiac function in vitro was assessed by the maximal positive and negative values of the first derivative of left ventricular pressure（＋dp/dtmax and-dp/dtmax） through langendorff heart perfusion apparatus.The contents of serum epinephrine,high sensitivity C-reactive protein（hs-CRP）,and angiotensin Ⅱ（Ang Ⅱ） were detected by enzyme linked immunosorbent assay（ELISA） at 0 h,6 h,12 h,and 24 h after trauma.Results Compared with the sham group,the cardiac functions of rats at 24h after trauma were significantly decreased.Epinephrine,hs-CRP and Ang Ⅱ in serum at 6 h,12 h,24 h after trauma were gradually increased in trauma groups and the contents of Ang Ⅱ in serum were negatively correlated with ＋dp/dtmax（r=-0.574,P＆lt;0.05）,and the contents of serum epinephrine were positively correlated with ＋dp/dtmax（r=0.402,P＆lt;0.05） at 24 h after trauma.However,there is no correlation between the contents of serum hs-CRP and ＋dp/dtmax（P＆gt;0.05）.Conclusion The excessive activation of Ang Ⅱ in circulatory system might be correlation with delayed cardiac dysfunction induced by mechanical trauma and the concentration of serum Ang Ⅱ might be treated as a screening indicator for delayed cardiac dysfunction induced by mechanical trauma.