磁共振成像评估促红细胞生成素对肾移植的治疗效果  

Evaluation of the therapeutic effect of erythropoietin in renal transplantation by magnetic resonance imaging

作　　者：徐鑫梅 胡婷婷 陈海 梁国标 容松 Xu Xinmei;Hu Tingting;Chen Hai;Liang Guobiao;Rong Song(Center for Experiment and Teaching of Clinical Skills,Affiliated Hospital of Zunyi Medical University,Zunyi 563003,China;Department of Nephrology,Affiliated Hospital of Zunyi Medical University,Zunyi 563003,China;Department of Nephrology,the Third Affiliated Hospital of Zunyi Medical University,Zunyi 563099,China;Department of Urology,Affiliated Hospital of Zunyi Medical University,Zunyi 563003,China;Center of Organ transplantation,Zunyi Medical University,Zunyi 563003,China)

机构地区：[1]遵义医科大学附属医院临床技能实验教学中心,563003 [2]遵义医科大学附属医院肾内科,563003 [3]遵义医科大学第三附属医院肾内科,563099 [4]遵义医科大学附属医院泌尿外科,563003 [5]遵义医科大学器官移植实验室,563003

出　　处：《中华实验外科杂志》2021年第3期493-495,共3页Chinese Journal of Experimental Surgery

基　　金：国家自然科学基金(81260056);贵州省教育厅创新群体重大研究项目(黔教合KY字[2017]045)。

摘　　要：目的观察磁共振成像评估促红细胞生成素(EPO)对肾移植的治疗效果,探讨EPO供体给药和EPO受体给药作用的机制。方法建立单侧大鼠同系基因肾移植模型,采用随机数字表法随机分为假手术组、模型组、EPO供体给药组、EPO受体给药组。术后24 h各组先行磁共振成像检查,通过冠状位扫描记录动脉自旋标记(ASL)及T1、T2成像,然后处死大鼠,取血检测肾功能,取肾做病理学检查,免疫组织化学或蛋白质印迹法(Western blot)检测肾损伤分子-1(KIM-1)、肿瘤坏死因子-α(TNF-α)、单核细胞趋化蛋白-1(MCP-1)的表达水平。采用单因素方差分析多组间及t检验分析两组间差异情况。结果两EPO给药组与模型组比较移植肾损伤明显减轻,肾功能、肾组织病理学变化明显改善,磁共振扫描显示模型组T1与T2时间[(1842.0±51.0)、(57.3±3.1)ms]均高于EPO供体给药组[(1412.0±33.0)、(41.4±1.9)ms]和EPO受体给药组[(1461.0±35.0)、(44.2±1.7)ms,F=94.433、35.546,P值均<0.01],差异均有统计学意义;KIM-1、TNF-α、MCP-1模型组表达(24.33±7.44、13.88±3.47、0.47±0.11)均高于EPO供体给药组(7.91±2.08、7.31±1.03、0.30±0.09)和EPO受体给药组(8.07±1.55、7.62±1.23、0.29±0.09,F=34.273、41.055、51.825,P值均<0.01),差异均有统计学意义。结论EPO可通过减少炎性因子生成等,减轻移植后的肾缺血再灌注损伤,无论供体给药还是受体给药,其效果相当,都发挥肾脏保护作用,说明EPO既在肾脏发挥作用也在血循环中发挥作用;而磁共振扫描结果与免疫组织化学及Western blot结果呈对应关系,证实EPO的治疗效果,磁共振成像这种无创性检查有助于临床判断药物治疗移植术后效果。Objective To evaluate the therapeutic effect of erythropoietin(EPO)in renal transplantation with magnetic resonance imaging(MRI)and to study the mechanism of donor EPO treatment group and recipient EPO treatment group.Methods The model was established by the unilateral isogenic renal transplantation in rats.These rats were randomly divided into sham-operated group,isogenic renal transplantation control group,donor EPO treatment group and recipient EPO treatment group.At 24 h after surgery,renal perfusion was measured using arterial spin labeling(ASL)and T1,T2 mapping before sacrifice.The renal function and morphological changes were observed.The expression of kidney injury molecule-1(KIM-1),tumor necrosis factor-α(TNF-α)and monocyte chemotactic protein-1(MCP-1)in the kidney was assessed by immunohistochemistry or Western blotting.One-way analysis of variance was used to analyze the differences between multiple groups and t test between the two groups.Results In comparison with the control group,the ischemia reperfusion injury were significantly reduced by two EPO treatment groups,the renal function and the pathological changes of kidney were significantly improved;MRI showed that the time of T1 and T2 in the control group was(1842.0±51.0)msand(57.3±3.1)ms,significantly longer than donor EPO treatment group[(1412.0±33.0),(41.4±1.9)ms]and recipient EPO treatment group[(1461.0±35.0),(44.2±1.7)ms,F=94.433,35.546,P<0.01];The levels of KIM-1,TNF-αand MCP-1 expression in the control group(24.33±7.44,13.88±3.47,0.47±0.11)were increased significantly as compared with those in donor EPO treatment group(7.91±2.08,7.31±1.03,0.30±0.09)and recipient EPO treatment group(8.07±1.55,7.62±1.23,0.29±0.09).Conclusion EPO may reduce ischemia reperfusion injury through reducing inflammatory factors expression after renal transplantation.The protective effect of renal function by two EPO treatment groups is the same,suggesting that EPO may play not only a role in kidney but also in blood circulation.The results of MRI

关 键 词：促红细胞生成素 核磁共振成像 缺血再灌注损伤 

分 类 号：R445.2[医药卫生—影像医学与核医学] R699.2[医药卫生—诊断学]