阿托伐他汀对肾功能不全大鼠造影剂诱导的急性肾小管损伤的保护作用  

Role of atorvastatin in protecting rats with renal insufficiency against contrast-induced acute renal tubular injury

作　　者：董国峰[1] 高希春[1] 吴尚勤[2] 赵鸿铭[3] 毛用敏[3] 

机构地区：[1]山东大学齐鲁医院桓台分院心内科,256400 [2]天津市胸科医院心内科 [3]天津市心血管病研究所

出　　处：《中华老年心脑血管病杂志》2013年第7期758-761,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨非离子低渗造影剂碘海醇对轻度肾功能不全大鼠肾小管的急性损伤作用,以及不同剂量的阿托伐他汀对肾小管损伤的保护作用。方法 36只轻度肾功能不全模型大鼠随机分为模型组、碘海醇组、阿托伐他汀小剂量组(小剂量组)、阿托伐他汀大剂量组(大剂量组),每组9只。另选9只为假手术组。注射后24、72h、7d每组监测血尿素、肌酐、尿液中肾损伤分子1(KIM-1)、N-乙酰-β-D-氨基葡萄糖苷酶(NAG)水平,HE染色观察肾小管结构变化,并计算肾小管损伤危险评分,TUNEL染色检测肾小管细胞凋亡率。结果与模型组比较,碘海醇组72h尿素、各时间点肌酐、KIM-1、NAG、肾小管损伤危险评分、细胞凋亡率明显升高(P<0.05,P<0.01);与碘海醇组比较,大剂量组24h、7d肌酐明显降低(P<0.05),各时间点KIM-1、NAG、肾小管损伤危险评分、细胞凋亡率明显降低(P<0.01)。结论在肾功能不全基础上注射低渗造影剂碘海醇能够对肾小管产生急性损伤作用,造影剂注射前连续给予阿托伐他汀能减轻该损伤,并且大剂量阿托伐他汀该保护作用更强。Objective To study the role of atorvastatin in protecting rats with mild renal insuffi- ciency against iohexol （a non-ionic low osmolar contrast） -induced acute renal tubular injury. Methods Thirty-six male Wistar rats with mild renal insufficiency were randomly divided into model group,iohexol group,low atorvastatin dose group and high atorvastatin dose group （9 in each group）. Another 9 rats served as a sham operation group. Three rats in each group were kill- ed 24 h,72 h and 7 days after iohexol injection. Their serum urea nitrogen and creatinine levels and urinary KIM-1, NAG levels were measured. Renal tubular structure was observed under opti- cal microscope with HE staining and renal tubular injury risk was scored. Apoptosis of renal tubu lar cells was detected with TUNEL staining. Results The serum urea nitrogen level 72 h after the model was established, and the serum creatinine level, urinary KIM-1 and NAG levels, renal tubu- lar injury score,and apoptosis rate of renal tubular cells were significantly higher in iohexol group than in model group 24 h,72 h and 7 days after iohexol injection. However,the serum creatinine level 24 h and 7 days after iohexol injection,the urinary KIM-1 and NAG levels,renal tubular in- jury score,and apoptosis rate of renal tubular cells were significantly lower in high atorvastatin dose group than in iohexol group at different time points （P〈0. 05, P〈0. 01）. Conclusion Iohexol can lead to acute renal tubular injury in patients with renal insufficiency,and atorvastatin, especially high atorvastatin dose,can reduce it before iohexol injection.

关 键 词：降血脂药 肾功能不全 肾小管 细胞凋亡 造影剂 

分 类 号：R96[医药卫生—药理学]