经腹肾次全切建立大鼠心肾综合征模型  

Establishment of rat model of cardiorenal syndrome by transabdominal subtotal nephrectomy

作　　者：曹浩[1] 吉霆威 兰琴[2] 林芳[2] 董云[3] 徐安军 刘静 丁海燕[1] 范慧敏[2] 刘中民[1] Cao Hao;Ji Tingwei;Lan Qin;Lin Fang;Dong Yun;Xu Anjun;Liu Jing;Ding Haiyan;Fan Huimin;Liu Zhongmin(Department of Cardiovascular Surgery,Shanghai East Hospital,Tongji University School of Medicine, Shanghai 200120,China;Shanghai Institute of Heart Failure,Shanghai East Hospital,Tongji University School of Medicine,Shanghai 200120,China;Department of Echocardiography,Shanghai East Hospital, Tongji University School of Medicine,Shanghai 200120,China)

机构地区：[1]同济大学附属东方医院心外科,上海200120 [2]同济大学附属东方医院上海市心力衰竭研究中心,上海200120 [3]同济大学附属东方医院心超室,上海200120

出　　处：《中华医学杂志》2019年第6期447-452,共6页National Medical Journal of China

基　　金：国家自然科学基金(81400363);科技部国家重点研发计划(2017YFA0105600);上海市科学技术委员会项目(17431906600).

摘　　要：目的 评估经腹肾次全切除术(STNx)后大鼠肾功能和心功能的变化,为慢性肾脏病(CKD)和心肾综合征(CRS)研究提供一个理想动物模型。 方法 将20只SD大鼠(雄性,5~6周龄)随机分为假手术(Sham)组及STNx组,每组10只。STNx组大鼠经腹一次性完成右肾切除+左肾2/3动脉结扎;Sham组大鼠仅完成手术操作,但不结扎右肾动静脉及输尿管,不切除右肾,不结扎左肾动脉分支。术后12周,行心脏超声观察心功能的变化,检测大鼠血清肌酐及肾脏病理变化,同时观察心肌细胞大小及纤维化情况。 结果 术后12周,STNx组大鼠一般状况较差,体型消瘦,梗死区肾组织吸收,表面凹凸不平,残余肾组织代偿性肥大。STNx组大鼠血清肌酐高于Sham组[(52.80±3.34)μmol/L比(22.10±1.64)μmol/L,P<0.001],差异有统计学意义。心脏超声检查结果显示,与Sham组比较,STNx组左室室壁增厚,心室容积减少,舒张功能下降,同时合并收缩功能下降(均P<0.05)。HE染色显示,Sham组肾小球、肾小管及肾间质形态正常,STNx组肾小球硬化。Masson染色显示,Sham组肾脏中纤维组织分布正常,STNx组见肾小球、肾小管及肾间质严重纤维化;心肌组织麦胚凝集素(WGA)染色显示,STNx组心肌细胞相对大小为1.293±0.060,Sham组为1.000±0.059,两组比较差异有统计学意义(P<0.001);HE染色显示STNx组部分心肌组织坏死、纤维化;Masson染色见STNx组局部心肌组织严重纤维化。 结论 经腹肾次全切除术建立大鼠CKD模型观察到类似人CKD中的病理生理变化,这种模型的心脏效应,可能使其成为研究心肾综合征的理想选择。Objective To evaluate the changes of rat renal function and cardiac function after transabdominal subtotal nephrectomy (STNx) and provide an ideal animal model for the study of chronic kidney disease (CKD) and cardiorenal syndrome (CRS). Methods The SD rats (male, 5-6 weeks) were randomly divided into Sham group (n=10) and STNx group (n=10). The rats from Sham group underwent sham surgery, and the right nephrectomy plus the 2/3 left kidney artery ligation through abdominal incision were performed in the rats from STNx group. Twelve weeks after operation, the rat serum creatinine and renal pathology were examined, the size and fibrosis of cardiac cells were also observed, after the changes of cardiac function being detected by echocardiography. Results Twelve weeks after the operation, STNx group rats were generally in poor condition, with a emaciated body, absorption of the renal infarct tissue, uneven surface, and residual renal tissue compensatory hypertrophy. The serum creatinine in Sham group and STNx group was (22.10±1.64) μmol/L and (52.80±3.34) μmol/L, respectively, and there was a statistically significant difference between the two groups (P<0.001). Compared with Sham group, the echocardiography results demonstrated that the thickness of left ventricular wall of rats from STNx group increased, the left ventricular volume decreased, and the diastolic and systolic function of left ventricular descended. The HE staining showed that the glomerulus, tubules and interstitial renal morphology were normal in Sham group, and glomerular sclerosis was observed in STNx group. And the Masson staining declared that the renal fibrous tissue distribution was normal in Sham group, and severe renal interstitial fibrosis was observed in STNx group. The wheat germ agglutinin (WGA) staining of myocardial tissue showed that myocardial cells in STNx group were larger than those in Sham group (1.293±0.060 vs 1.000±0.059, P<0.001). Moreover, the HE staining showed that there was partial myocardial tissue necrosis and fibro

关 键 词：心肾综合征 慢性肾脏病 肾切除术 心功能 模型 动物 

分 类 号：R541.6[医药卫生—心血管疾病]