不同输血输液方案对失血性休克大鼠肾功能及AQP2,BSC1的影响  

Comparison of different blood and fluid transfusion strategy on renal function,AQP2,BSC1of hemorrhagic shock in rats

作　　者：李凯[1] 高凤[1] 冷亚书 赵国庆[1] 李龙云[1] 

机构地区：[1]吉林大学中日联谊医院,吉林长春130033

出　　处：《中国实验诊断学》2014年第8期1222-1225,共4页Chinese Journal of Laboratory Diagnosis

基　　金：吉林省自然科学基金项目(20115095)

摘　　要：目的利用重度失血性休克大鼠模型,探讨不同输血输液方案对肾脏病理、肾功能、水通道蛋白-2(aquaporins-2water channel,AQP2),Na+-2Cl--K+协同转运蛋白-1(Na+-2Cl--K+co-transporter-1,BSC1)影响的差异及相关机制。方法 24只鼠随机分为C组(对照组)、LR组(血液与乳酸钠林格按1∶2稀释后,回输2/3)和HES组(血液与羟乙基淀粉按1∶2稀释后,回输2/3),每组8只,C组仅行股动静脉插管,其余两组经股动脉放血35%,使平均动脉压低于40mmHg达60min,建立大鼠急性失血性休克模型后,按方案输血输液后,缝合苏醒。24h后再次麻醉取材观察肾组织的病理学变化,并测定血清中肌酐(Cr)和尿素氮(BUN)含量,采集并记录尿量,检测尿比重,采用免疫组织化学及Western blot法分别对肾组织AQP2、BSC1进行定性和定量分析。结果与C组比较:1两组尿量增加,尿比重降低,组间无明显差异。2两组血清BUN、Cr水平均显著增加,两组间无差异。3两组肾组织病理损伤分级显著升高,两组间无差异。4Western blot及免疫组织化学结果显示,两组BSC1、AQP2蛋白表达表达均下调,HES组表达高于LR组。结论急性重度失血性休克能够引起肾脏损伤,与BSC1,AQP2蛋白的下调相关。血液与羟乙基淀粉1∶2混合输注的方案,对肾脏的保护作用优于血液与林格液方案,并可显著降低BSC1,AQP2蛋白的改变。Objective To investigate the differences of blood and fluid transfusion strategy on renal function,AQP2 and BSC1of hemorrhagic shock in rats.Methods 24 SD rats were randomly divided into C group（control）,LR group（2/3of mixture of blood and lactate Ringer＇s diluted as 1∶2is infused）,HES group（2/3of mixture of blood and hydroxyethyl starch diluted as 1∶2is refused）.C group are cathetered in femoral artery and vein.The other two groups are inflicted by 35% hemorrhage and MAP 〈40mmHg to make moderate hemorrhagic shock model for 60 min.According to schedule,different fluid are transfused.24 hlater,renal pathology,serum creatine（Cr）,blood urea nitrogen（BUN）,urine specific gravity and volume.AQP2 and BSC1are detected by immunohistochemistry and Western blot.Results Compared with C group：（1）Decrease of urine specific gravity and increase of urine volume are observed in the other two groups,meanwhile,no significant difference existed in the two group.（2）The level of BUN and Cr are rose in LR group and HES group which are almost equally.（3）The tubular Paller＇s score in LR group and HES group were all higher than group C（P〈0.05）.the score in the two group had no significant difference（P〉0.05）.（4）Upregulation of BSC1 and AQP2appeared in the other two group.The HES group had lower level than LR gruop.Conclusion The kidney failure can be inspired by acute hemorrhagic shock which is related to BSC1 and AQP2.Blood combined with HES had better resuscitative effect than with LR in terms of BSC1 and AQP2.

关 键 词：失血性休克 羟乙基淀粉 乳酸钠林格注射液 肾 BSC1 AQP2 

分 类 号：R457[医药卫生—治疗学] R459.7[医药卫生—临床医学]