丙酮酸盐腹膜透析液腹腔复苏对大鼠肾脏缺血再灌注损伤的作用  

Effect of peritoneal resuscitation with pyruvate peritoneal dialysate on renal ischemia reperfusion injury in rats

作　　者：张琼月[1] 张婧婧[1] 蒋琳琳[1] 吴唐静 张宗泽[1] 王焱林[1] Qiong-Yue ZHANG;Jing-Jing ZHANG;Lin-Lin JIANG;Tang-Jing WU;Zong-Ze ZHANG;Yan-Lin WANG(Department of Anesthesiology,Zhongnan Hospital of Wuhan University,Wuhan 430071,China)

机构地区：[1]武汉大学中南医院麻醉科,武汉430071

出　　处：《医学新知》2022年第2期138-144,共7页New Medicine

基　　金：国家自然科学基金项目(81601678)。

摘　　要：目的 研究丙酮酸盐腹膜透析液腹腔复苏对失血性休克复苏后大鼠肾脏缺血再灌注损伤的保护作用及其可能机制。方法 40只健康雄性SD大鼠随机分为假手术组(Sham组)、静脉复苏组(VR组)、生理盐水腹腔复苏组(NR组)、丙酮酸盐腹膜透析液腹腔复苏组(PR组)4组,每组10只。VR组、NR组与PR组制备失血性休克大鼠模型,Sham组仅行右颈总动脉、左股动脉、右股静脉穿刺及全身肝素化。复苏后24 h采集标本,使用血液分析仪检测肌酐和尿素氮浓度,HE染色观察肾组织病理学结果并进行Paller评分,ELISA法检测肾组织IL-1β、TNF-α含量,Western blot法测定p-STAT3、p-JAK2的表达水平。结果 与Sham组相比,VR组、NR组与PR组肾小管Paller评分、血清肌酐及尿素氮水平均升高,IL-1β、TNF-α含量增加,p-STAT3、p-JAK2表达水平上调(P <0.05)。与VR组、NR组相比,PR组肾小管Paller评分、血清肌酐及尿素氮水平降低,IL-1β、TNF-α含量减少,p-STAT3、p-JAK2表达水平下调(P <0.05)。结论 丙酮酸盐腹膜透析液腹腔复苏能够减轻失血性休克复苏后肾缺血再灌注损伤,改善肾功能,其机制可能与降低炎症反应、抑制JAK2/STAT3信号通路的激活有关。Objective To study the protective effect and possible mechanism of peritoneal resuscitation with pyruvate peritoneal dialysate on renal ischemia reperfusion injury after hemorrhagic shock resuscitation in rats. Methods 40 rats were randomly divided into four groups: sham operation group(sham group), intravenous resuscitation group(VR group),normal saline peritoneal resuscitation group(NR group), pyruvate peritoneal dialysis fluid peritoneal resuscitation group(PR group). The rat model of hemorrhagic shock was performed on VR, NR and PR groups. In the sham group, right common carotid artery, left femoral artery and right femoral vein were punctured and heparinized. Blood and kidney tissues were collected from all groups 24 hours after resuscitation. Serum creatinine and urea nitrogen concentrations were detected by hematology analyzer. Renal histopathological results were observed by HE staining and Paller score was performed. The levels of IL-1β and TNF-α were detected by ELISA. The expression levels of p-STAT3 and p-JAK2 were determined by Western blot. Results Compared with sham group, the renal tubular Paller score, serum creatinine and urea nitrogen levels in VR, NR and PR groups were increased, the contents of IL-1 β, TNF-α and the expressions of p-STAT3 and p-JAK2 were increased(P<0.05). Compared with VR and NR groups, the renal tubular Paller score, serum creatinine and urea nitrogen levels were decreased,the contents of IL-1β, TNF-α and the expressions of p-STAT3 and p-JAK2 were decreased in PR group(P<0.05). Conclusion Pyruvate peritoneal dialysate peritoneal resuscitation can reduce renal ischemia reperfusion injury and improve renal function after hemorrhagic shock resuscitation. The mechanism may be related to reducing inflammatory response and inhibiting the activation of JAK2/STAT3 signaling pathway.

关 键 词：丙酮酸盐腹膜透析液 腹腔复苏 肾缺血再灌注 炎症反应 JAK2/STAT3通路 

分 类 号：R605.971[医药卫生—急诊医学]