血液透析疗法对急性肾损伤模型犬治疗效果的研究  

Study on the therapeutic effect of hemodialysis therapy on acute kidney injury model dogs

作　　者：孟慧 周闯[1] 陈海捷 陈宝珠 赵彬[1] 刘国芳[1] 郑浩 张海彬[3] MENG Hui;ZHOU Chuang;CHEN Haijie;CHEN Baozhu;ZHAO Bin;LIU Guofang;ZHENG Hao;ZHANG Haibin(Jiangsu Vocational College of Agriculture and Forestry,Jurolig 212400,China;Shanghai Xinyuan Animal Medicine Co.,Ltd.,Shanghai 201800,China;Nanjing Agricultural University,Nanjing 210095,China)

机构地区：[1]江苏农林职业技术学院,江苏句容212400 [2]上海信元动物药品有限公司,上海201800 [3]南京农业大学,南京210095

出　　处：《黑龙江畜牧兽医》2021年第20期55-60,153,共7页Heilongjiang Animal Science And veterinary Medicine

基　　金：江苏农林职业技术学院科技项目“CRRT技术配合肾脏处方粮对犬AKI治疗效果的研究”(2019KJ026);江苏农林职业技术学院大学生创新创业训练计划项目“CRRT技术配合肾脏处方粮对犬AKI治疗效果的研究”(201913103002y)。

摘　　要：为了探讨血液透析疗法对犬急性肾损伤(AKI)的治疗效果,提高患AKI犬的存活率,促进血液透析疗法在宠物临床的推广,试验将30只试验犬分为5组,每组6只,分别为健康对照组(A组)、常规治疗组(B组)、血液透析治疗1组(C组)、血液透析治疗2组(D组)、AKI对照组(E组)。A组试验犬不进行AKI造模,自由饮水和采食。B、C、D、E组试验犬同时进行AKI造模,每天将盐酸庆大霉素注射液按体重90 mg/kg与基础液0.9%氯化钠注射液200 mL混合后静脉注射,检测B、C、E组试验犬血清肌酐(CREA)浓度达到AKIⅡ级(141~220μmol/L)或Ⅲ级(221~439μmol/L)时停止给药;检测D组试验犬血清CREA浓度达到AKIⅣ级(440~880μmol/L)或Ⅴ级(>880μmol/L)时停止给药。AKI造模成功后,B组采用常规治疗方法,C组、D组采用血液透析结合对症治疗,E组试验犬造模成功后不做任何处理,自由饮水和饮食,试验周期7 d。治疗过程中观察试验犬的临床表现,每天检测尿比重、尿沉渣,血清肌酐(CREA)、尿素氮(BUN)、钾离子、磷浓度及血细胞比容(HCT),治疗7 d后,统计试验犬的存活率,对试验犬进行肾脏病理组织学检查,综合比较治疗效果。结果表明:C组与B组相比,第1天治疗后血清CREA、BUN显著降低(P<0.05);第2天治疗结束后,尿比重、血清钾离子、磷浓度显著降低(P<0.05),HCT显著提高(P<0.05)。C组试验犬在第2天治疗结束后磷浓度降低至6.3 mg/dL;第3天治疗结束后尿比重降低至1.045,血清BUN浓度降低至23.7 mg/dL;第4天治疗结束后血清CREA浓度降低至138.3μmol/L,钾离子浓度降低至5.2 mmol/L;第7天治疗结束后尿沉渣镜检显示管型消失,白细胞数降至正常范围内(每个高倍视野<5个),肾脏病理组织学检查仅发现肾小球毛细血管及间质毛细血管瘀血;试验过程中未出现死亡情况。D组试验犬在第5天治疗结束后尿比重降低,血清BUN浓度降低至22.9 mg/dL,钾离子浓度降低至5.3 mmol/L,磷浓度In order to explore the therapeutic effect of hemodialysis therapy on canine acute kidney injury(AKI),improve the survival rate of dogs suffering from AKI,and promote the spread of hemodialysis therapy in pet clinics, the trial divided 30 test dogs into five groups, six each group, namely the healthy control group(group A),the conventional treatment group(group B),the hemodialysis treatment group 1(group C),the hemodialysis treatment group 2(group D),and the AKI control group(group E). The test dogs of group A did not undergo AKI modeling, being free to drink and eat. Dogs in groups B,C,D,and E were simultaneously modeled with AKI;gentamicin hydrochloride was mixed with a body weight of 90 mg/kg and 200 mL of base solution of 0.9% sodium chloride injection and injected intravenously every day. The administration was stopped when the serum creatinine(CREA) concentration of test dogs in groups B,C and E reached AKI grade Ⅱ(141-220 μmol/L) or grade Ⅲ(221-439 μmol/L);the administration was stopped when the serum CREA concentration of test dogs in group D reached AKI grade Ⅳ(440-880 μmol/L) or grade Ⅴ(>880 μmol/L). After the AKI was successfully modeled, the B group adopted conventional treatment method, the C and D groups were given hemodialysis combined with symptomatic treatment, and the test dogs of the E group were successfully modeled without any treatment;they were free to drink and eat. The test period was 7 d. The clinical manifestations of the test dogs during the treatment were observed;daily measurement of urine specific gravity, urine sediment, serum CREA,urea nitrogen(BUN),potassium ion, phosphorus concentration and hematocrit(HCT) was carried out. After 7 days of treatment, the survival rate of the test dogs was counted, and histopathological examination of the kidneys was performed on the test dogs to comprehensively compare the treatment effect. The results showed that compared with group B,serum CREA and BUN in group C were significantly reduced after the first day of treatment(P<0.05).Af

关 键 词：犬 急性肾损伤 庆大霉素 血液透析 肌酐 尿素氮 尿液 

分 类 号：S854.59[农业科学—临床兽医学] S856.59[农业科学—兽医学]