异丙酚后处理对脓毒症所致大鼠急性肾损伤的影响  

Effects of postconditioning with Propofol on acute renal injury induced by sepsis in rats

作　　者：董承舒[1] 张晓丽[1] 李国福[1] 吉凯强[1] 臧彬[1] 

机构地区：[1]中国医科大学附属盛京医院ICU,辽宁沈阳110004

出　　处：《中国现代医学杂志》2013年第11期7-11,共5页China Journal of Modern Medicine

基　　金：辽宁省科技厅科学技术计划项目(No:2010225034)

摘　　要：目的观察异丙酚后处理对脓毒症所致大鼠急性肾损伤肾组织细胞bcl-2、bax表达的影响,并探讨其肾保护机制。方法 24只雄性SD大鼠随机分为3组:假手术组(S组)、脓毒症组(CLP组)与异丙酚后处理组(PROP组),每组8只。除S组外,其余两组均行盲肠结扎穿孔术(CLP)。24 h后,S组及CLP组给予大鼠腹腔注射生理盐水50 mg/kg,PROP组给予大鼠腹腔注射1%丙泊酚50 mg/kg。应用代谢笼记录大鼠48 h尿量。48 h后处死大鼠。腹主动脉抽血测定血清肌酐(SCr)及尿素氮(BUN)含量;免疫组织化学法检测肾脏中bcl-2、bax蛋白的表达变化,并作肾组织病理形态学检查。结果脓毒症可致肾功能损伤,CLP组与S组相比,SCr、BUN有升高趋势,但差异无统计学意义(P>0.05);bcl-2、bax表达升高,有统计学意义(P<0.01);超微结构显示较S组加重。与CLP组相比,PROP组SCr、BUN浓度降低,但差异无统计学意义(P>0.05);bcl-2表达明显升高(P<0.01),从而提高了bcl-2与bax的比例;超微结构显示组织损伤较CLP组减轻。结论异丙酚后处理可以减轻脓毒症所致肾脏损伤,其保护机制可能与提高bcl-2与bax的比例,从而抑制脓毒症所致的肾组织细胞凋亡有关。【Objective】 To investigate the effects of postconditioning with Propofol on the expression of bcl-2 and bax in sepsis-induced renal injury and its mechanism.【Methods】 Twenty-four male SD rats were equally randomized into 3 groups（n =8）： sham operation group（S）,sepsis group（Cecum ligation perforation,CLP） and Propofol postconditioning group（PROP）.CLP operation was conducted on the rats except for the S group.50 mg/kg normal saline for S and CLP group and 50 mg/kg Propofol for PROP group was injected respectively into the abdominal cavity of the rats after 24 h.Rats were killed 48 h after surgery,and blood from their abdominal aorta was collected to determine the serum creatinine（SCr） and urea nitrogen（BUN） level.Expressions of bcl-2 and bax in kidney were evaluated by immunohistochemical method.Renal pathological morphology examination was also conducted.【Results】 There was a rising trend of SCr and BUN in group CLP compared with group S,whereas the difference was not significant（P 0.05）,but the bcl-2 and bax express rose significantly（P 0.01） and the ultrastructure lesions were more severe in CLP group.Compared with CLP group,PROP group had a lower SCr and BUN level,though the difference was also not significant（P 0.05）.However bcl-2 expression increased significantly（P 0.01） in PROP group,elevated the ratio of bcl-2 and bax,PROP group had less ultrastructure damage.【Conclusions】 Postconditioning with Propofol can reduce sepsis-induced renal damage.The protection effect may be related with elevated the ratio of bcl-2 and bax,thus inhibiting sepsis-induced cell apoptosis after renal injury induced by sepsis.

关 键 词：肾脏 脓毒血症 后处理 BC1-2 异丙酚 

分 类 号：R692[医药卫生—泌尿科学] R631[医药卫生—外科学]