N-乙酰半胱氨酸对低渗对比剂急性肾损伤模型大鼠肾组织的影响  

Effect of N-acetylcysteine Intervention on Contrast-induced Kidney Injury in Experimental Rats

作　　者：王琳[1] 李文华[1] 陈静[1] 何海燕[1] 余亚仁 

机构地区：[1]徐州医学院附属医院心内科,江苏省徐州市221002

出　　处：《中国循环杂志》2015年第2期168-171,共4页Chinese Circulation Journal

摘　　要：目的:通过建立大鼠低渗对比剂急性肾损伤动物模型,观察N-乙酰半胱氨酸(NAC)干预后肾损伤的变化,从而对临床治疗对比剂诱导的急性肾损伤提供理论依据。方法:清洁级雄性SD大鼠随机分为正常对照组(n=15),对比剂肾损伤模型组(对比剂损伤组,n=15),N-乙酰半胱氨酸对照组(n=15)及N-乙酰半胱氨酸治疗组(治疗组,n=15)。分别于造模后第24 h、48 h、72 h处死动物,并检测血肌酐值,病理切片及苏木素-伊红(HE)染色评估肾小管损伤程度,试剂盒检测肾组织氧化应激指标丙二醛(MDA)含量、总超氧化物歧化酶(T-SOD)的活性。结果:1与正常对照组和N-乙酰半胱氨酸对照组相比,对比剂损伤组在建模后第48 h、72 h血清肌酐值显著升高(P<0.01),治疗组在相同时间点较对比剂损伤组血清肌酐值显著下降(P<0.01);2 HE染色可见对比剂损伤组在建模后24 h至72 h均出现不同程度的急性肾小管损伤,伴或不伴上皮细胞刷状缘脱落、空泡变性、细胞脱落及再生,部分肾小管结构破坏;与正常对照组和N-乙酰半胱氨酸对照组比较,对比剂损伤组和治疗组肾小管损伤评分显著升高(P<0.05),治疗组在相同时间点较对比剂损伤组肾小管损伤评分显著降低(P<0.05),差异均有统计学意义;3与正常对照组和N-乙酰半胱氨酸对照组比较,氧化应激标志物丙二醛含量、T-SOD活性在对比剂损伤组和治疗组变化显著(P<0.01),治疗组与对比剂损伤组比较差异亦有统计学意义(P<0.05)。结论:N-乙酰半胱氨酸可以减轻低渗对比剂诱导的急性肾小管上皮细胞的损伤。Objective：To observe the effect of N-acetylcysteine （NAC） intervention on contrast-induced acute kidney injury in experimental rats, in order to provide the theoretical basis for treating such injury in clinical practice. Methods： A total of 60 male SD rats were randomly divided into 4 groups： ① Control group, with normal rats, ② Contrast-induced nephropathy （CIN） group, ③ NAC group, the rats received NAC pre-treatment followed by normal saline injection, ④Treatment group, the rats received NAC pre-treatment followed by contrast media injection. n=15 in each group. The animals were sacriifced at 24 h, 48 h and 72 h respectively after modeling. The renal function was evaluated by serum creatinine, tissue injury was examined by HE-staining and the renal oxidative stress condition was measured by MDA and T-SOD activities. Results：①Compared with Control group, CIN group showed obviously increased serum creatinine levels at 48 h, 72 h after the modeling, P〈0.01, while compared with CIN group, the creatinine levels were lower in Treatment group at the same time points, P〈0.01.②HE-staining presented that CIN group had different levels of acute tubular injury, with or without brush border epithelial cell shedding, vacuolar degeneration, cell loss and regeneration and partially tubular structural damage at 24 h, 72 h after the modeling;compared with Control group and NAC group, the renal injury scores in CIN group and Treatment group were significantly increased, P〈0.05, while Treatment group had much less renal injury than CIN group at the same time points, P〈0.05.③Compared with Control group and NAC group, the MDA and T-SOD activities were obviously changed in CIN group and Treatment group, P〈0.01, the MDA and T-SOD activities were different between Treatment group and CIN group, P〈0.05. Conclusion： NAC may reduce the injury of renal tubular epithelial cells in contrast-induced nephropathy in experimental rats.

关 键 词：对比剂肾病 N-乙酰半胱氨酸 血肌酐 肾小管损伤 

分 类 号：R54[医药卫生—心血管疾病]