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作 者:曹波[1] 张琳琳[1] 柴春香[1] 赵学兰[1] 张培荣[1] 陈学勋[1]
出 处:《中国当代医药》2014年第6期11-14,共4页China Modern Medicine
摘 要:目的探讨乌司他丁对盲肠结扎穿孔术(CLP)所致大鼠脓毒症急性肾损伤肾脏病理及尿相关指标的影响。方法 SD健康雄性大鼠55只,按随机化原则分成3组:正常对照组5只、模型组25只、乌司他丁治疗组25只,后两组再随机分为5个时间点(1、6、12、24、48 h),每组每时间点各5只,采用CLP复制脓毒症模型,乌司他丁治疗组造模后立即给予乌司他丁100 000 U/kg,尾静脉注射,分别在各个时间点采血、留尿标本,处死大鼠摘取肾脏,进行肾功能血肌酐(SCr)、尿素氮(BUN),尿肾损伤分子(KIM-1)、白细胞介素-18(IL-18)和中性粒细胞明胶酶相关脂质运载蛋白(NGAL)检测分析,光镜下观察肾脏病理变化。结果模型组SCr、BUN的浓度CLP术后6 h开始升高,24 h达高峰,48 h开始下降,均显著高于对照组(P<0.05),乌司他丁治疗组12、24、48 h均显著低于相应时间点模型组(P<0.05)。模型组尿KIM-1、NGAL、IL-18含量于CLP术后1 h开始升高,12 h达高峰,24 h开始下降,均显著高于对照组,乌司他丁治疗组6、12、24、48 h均显著低于相应时间点模型组(P<0.05)。肾脏病理改变明显好于模型组。结论乌司他丁对脓毒症所致急性肾损伤具有肾脏保护作用。Objective To discuss the influence of ulinastatin on renal pathology and relevant indexes of urine in rats with sepsis-induced acute kidney injury(AKI) caused by cecal ligation and puncture(CLP).Methods 55 cases of healthy and male SD rats were randomly divided into 3 groups: control group(n=5),model group(n=25),and ulinastatin group(n=25).The last two groups were then randomly divided into 5 points in time including 1 h,6 h,12 h,24 h,and 48 h with 5 rats in each time point.The sepsis model was duplicated by CLP.After successfully establishing the model,in the ulinastatin group,100 000 U/kg ulinastatin was administered for intravenous injection.The blood and urine was collected in the set 5 points in time.These rats were executed and relevant indexes like serum creatinine(SCr),blood urea nitrogen(BUN),kidney injury molecule-1(KIM-1),interleukin-18(IL-18),and neutrophil gelatinase associated lipocalin(NGAL) was tested and analyzed.Changes of renal pathology were observed under light microscope.Results In the model group,concentrations of SCr and BUN 6 h after CLP started to rise,reached peak in 24 h,and decreased in 48 h,which were all higher than those in the control group(P0.05).After ulinastatin therapy,the concentrations of Scr and BUN in 12 h,24 h,and 48 h were all lower than those in the corresponding points in time in the model group(P0.05).Contents of KIM-1,NGAL,and IL-18 1 h after CLP started to increase,reached peak in 12 h,and decreased in 24 h in the model group were all remarkably higher than those in the control group.After giving ulinastatin,the contents of KIM-1,NGAL, and IL-18 in 6 h,12 h,24 h,and 48 h were greatly lower than those in the corresponding points in time in the model group(P0.05).In the ulinastatin group,changes of renal pathology was better than that of the model group.Conclusion Ulinastatin plays the role of renal protection in AKI caused by sepsis.
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