摘要目的:观察辐射后高气压暴露动物损伤指标的变化，探讨辐射复合减压暴露后急性损伤效应，为复合伤救治提供参考依据。方法:选取雄性SD大鼠80只，按照随机数字表法分为3 h和48 h取材的对照组、减压组、辐照组和复合组（辐射+减压），共8组，每组10只，予以先辐射后减压处理。辐射方案采用 60Co γ射线进行全身单次照射，剂量为4 Gy，高气压暴露方案为57 m停留45 min后以（30±5）s匀速减至常压。减压后即刻观察大鼠的减压病（DCS）发病和死亡情况，分别于3 h和48 h行腹主动脉取血，采用酶联免疫吸附试验（ELISA）法检测各组大鼠血清白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、丙二醛（MDA）、一氧化氮（NO）、细胞间黏附分子1（ICAM-1）和血栓素B2（TXB2）的含量以及超氧化物歧化酶（SOD）的活性。 结果:减压组和复合组各死亡2只大鼠。3 h、48 h取材的复合组大鼠与相同时间点对照组和单一损伤组相比，血清IL-1β、IL-6、TNF-α、MDA、NO、ICAM-1和TXB2含量明显增加，差异均有统计学意义（ P<0.05）；与对照组和减压组相比，复合组大鼠血清中SOD活性明显降低，差异有统计学意义（ P<0.05）。 结论:辐射复合减压暴露急性损伤效应主要体现在机体的炎症反应增强、氧化损伤加剧、血管舒缩功能和出凝血功能受损，并且复合效应持续48 h依然存在；提示该类损伤的现场救治后送措施，需要针对复合损伤效应采取相应的处理措施。

abstractsObjective:To observe the changes of injury indexes of animals exposed to high pressure after radiation，and to study the acute injury effects of radiation combined with decompression exposure，so as to provide a reference for the treatment of the combined injury.Methods:Eighty male SD rats were randomly divided into eight groups（10 rats in each group）：control group，decompression exposure group，irradiation exposure group，and radiation combined with decompression（combined exposure）group for sampling 3 h and 48 h after intervention. Rats were exposed to radiation followed by decompression. The radiation exposure plan was a whole-body irradiation with a single dose of 4 Gy of 60Co γ rays. The high-pressure exposure plan was staying at 57 m for 45 minutes followed by a uniform reduction to normal pressure in（30 ± 5）seconds. The onset of decompression sickness（DCS）and subsequent death were observed immediately，and abdominal aortic blood was taken after 3 h and 48 h，respectively. The contents of IL-1β，IL-6，TNF-α，MDA，NO，ICAM-1，and TXB2 in serum，and the activity of superoxide dismutase（SOD），were detected by ELISA. Results:There were two death cases in the decompression exposure groups and the combined exposure groups，respectively. At the 3-hour sampling time point，compared with the control group and the single exposure group，the combined exposure group had significantly increased serum levels of IL-1β，IL-6，TNF-α，MDA，NO，ICAM-1，and TXB2（ P<0.05）. Compared with the control group and the decompression exposure group，the combined exposure group had significantly decreased SOD activity（ P<0.05）. Conclusion:The acute injury effects of radiation combined with decompression exposure were mainly reflected in the increased inflammatory response，aggravated oxidative damage，impaired vasomotor function，and coagulation function，and these combined effects persisted for 48 hours. These findings suggested that on-the-spot treatment and medical evacuation measures for this type of injury should not only focus on the single injury of radiation injury or DCS，but also consider the corresponding counter-measures for the combined injury effects.