高压氧辅助抗蛇毒血清治疗对五步蛇毒中毒大鼠肾保护作用研究  

Study of renal protective effect of antivenom therapy assisted with hyperbaric oxygen in agkistrodon acutus poisoning rat

作　　者：贺东坡 谢智慧[2] 喻安永[1] 李沫[1] HE Dongpo;XIE Zhihui;YU Anyong;LI Mo(Department of Emergency,Affiliated Hospital of Zunyi Medical College,Zunyi,Guizhou 563000,China;Department of Hyperbaric Oxygen,Affiliated Hospital of Zunyi Medical College,Zunyi,Guizhou 563000,China)

机构地区：[1]遵义医学院附属医院急诊科,贵州遵义563000 [2]遵义医学院附属医院高压氧科,贵州遵义563000

出　　处：《重庆医学》2018年第14期1862-1865,1869,共5页Chongqing medicine

基　　金：贵州省科技厅[黔科合SY字(2013)3067号]

摘　　要：目的探讨高压氧(HBO)辅助抗蛇毒血清治疗对五步蛇毒中毒大鼠肾的保护作用。方法将96只健康成年雄性SD大鼠随机分为对照组(A组)、蛇毒中毒组(B组)、血清治疗组(C组)、血清联合HBO治疗组(D组),每组24只。B、C、D组大鼠经尾静脉注射五步蛇蛇毒0.8×LD_(50)(LD_(50)=1.594mg/kg)建立中毒模型,观察五步蛇毒中毒后肾组织的病理变化。C组于建模成功后即从尾静脉注射抗蛇毒血清(0.8×78U/kg),D组于注射抗蛇毒血清后0、4、11、23h予以HBO治疗1次,A组不予任何处理。结果 B、C、D组静脉注射蛇毒后大鼠出现明显的中毒症状。与B组比较,C、D组大鼠肾功能、凝血功能明显改善(P<0.05),且D组优于C组(P<0.05)。B组大鼠出现肾小球出血、肾小囊扩张,周围毛细血管存在不同程度的充血,肾小管管腔扩张,可见细胞低平,刷状缘脱落,肾小管上皮细胞空泡化,肾间质组织炎性细胞浸润。随着中毒时间的延长肾出血减少,炎性细胞浸润增加。C、D组大鼠以上病变明显改善。结论五步蛇毒中毒可导致大鼠肾损伤;采用HBO辅助抗蛇毒血清治疗对五步蛇毒中毒大鼠肾损伤有保护作用,并且越早采用其保护效应越好。Objective To investigate the renal protective effect of antivenom therapy assisted with hyperbaric oxygen（HBO）in agkistrodon acutus poisoning rat.Methods Ninety-six healthy adult male SpragueDawley rats were randomized into the control group（group A）,snake venom poisoning group（group B）,antivenom treatment group（group C）and antivenom＋ HBO treatment group（group D）,24 cases in each group.The group B,C and D were injected with agkistrodon acutus toxin 0.8×LD_（50）（LD_（50）=1.594 mg/kg）by tail vein for establishing the poisoning model.The renal tissue pathological changes after agkistrodon acutus poisoning were observed.In the antivenom treatment group,antivenom（0.8×78 U/kg）was injected by tail vein after successfully constructing model,the group D was given once HBO treatment at 0,4,11 23 hafter antivenom injection,while the group A was not given any treatment.Results The rats appeared obvious poisoning symptoms after snake venom intravenous injection.Compared with the group B,the rat renal function and coagulation functions in the group C and D were significant improved,more over the group D was better than the group C（P〈0.05）.The rats of the group B appeared glomerular hemorrhage,renal capsule expansion,different degrees of congestion in peripheral blood capillaries,renal tubular cavity dilation,cellular fatness,falling of brush border,vacuolation of renal tubular epithelial cells and inflammary cells infiltration in renal interstitial tissue.Along with time lapse,the renal hemorrhage was decreased and inflammatory cells infiltration was increased.The above lesions in the group C and D were significantly improved.Conclusion The Agkistrodon acutus poisoning can lead to renal damage in rats;the antivenom treatment assisted with HBO has the protective effect on renal injury in agkistrodon acutus poisoning rat,moreover early adopting has better protective effect.

关 键 词：高压氧 抗蛇毒血清 五步蛇 肾损伤 

分 类 号：R459.7[医药卫生—急诊医学]