加入川穹嗪的乳酸钠林格灌注液对肾脏保存的影响  

Effects of Lactate Ringer's solution with Tetramethylpyrazine on kedney preservation

作　　者：高帅 池哲子 方潇 朱兰卉 戴天增 周智华 GAO Shuai;CHI Zhezi;FANG Xiao;ZHU Lanhui;DAI Tianzeng;ZHOU Zhihua(Department of Urology,Mengchao Hepatobiliary Hospital of Fujian Medical University,Fuzhou,Fujian 350001,China)

机构地区：[1]福建医科大学孟超肝胆医院,福州350001 [2]福州大学生物科学与工程学院

出　　处：《福建医药杂志》2023年第5期95-98,F0003,共5页Fujian Medical Journal

基　　金：福州市科技局社会发展项目-医疗项目(2020-WS-103)。

摘　　要：目的 探讨在大鼠器官获取模型的灌注环节,利用加入川穹嗪的乳酸钠林格灌注液替代高渗枸橼酸腺嘌呤液(HC-A液),对后续静态冷保存肾脏质量的影响。方法 建立大鼠肾脏获取模型,根据灌注液成分不同分为乳酸钠林格液(LRS)组、加入川芎嗪的乳酸钠林格液(TMP-LRS)组、高渗枸橼酸腺嘌呤液(HC-A)组,大鼠肾脏取下后进行静态冷保存(0~4℃)。根据保存时间阶段分为不同组:肾脏(0 h、6 h、12 h、24 h、36 h),利用光镜观察肾脏组织的病理改变,TUNEL法检测细胞凋亡,并检测细胞ATP酶活性。结果 在静态冷保存过程的6 h及后续时间点检测肾脏组织ATP酶活力,与HC-A与TMP-LRS组相比,LRS组最显著(P<0.01),各时间点TMP-LRS组与HC-A组相比差异无统计学意义(P>0.05)。肾脏组织光镜下病理改变主要表现为肾小管的肿胀、肾小管细胞坏死脱落、间质水肿、血管内皮细胞的坏死,24 h后变化明显,LRS组变化最显著。肾脏组织保存24 h时间点3组差异明显,灌注保存36 h后,TMP-LRS组凋亡水平较HC-A组低,但差异无统计学意义。结论 利用加入川穹嗪的乳酸钠林格液器官获取时进行灌洗,后续进行肾脏保存可取得与HC-A液相当的效果,可作为替代以降低医疗成本。Objective To investigate the effects of Lactate Ringer's solution with Tetramethylpyrazine as a substitute for hypertonic citrate adenine solution(HC-A solution)in the perfusion phase of rat organ acquisition model on the quality of kidney after static cold preservation.Methods An acquisition model was established,and the rats were divided into three groups according to the perfusion solution:Lactate Ringer's solution(LRS)group,Lactate Ringer's solution with Tetramethylpyrazine(TMP-LRS)group,and hypertonic citrate adenine solution(HC-A)group.After the liver and kidney were removed,they were subjected to static cold storage(0-4℃).The groups were based on the storage time:kidney(0 h,6 h,12 h,24 h,36 h).Pathological changes in organ tissues were observed by using photoscopic examination,cell apoptosis was detected by using TUNEL method,and cell ATPase activity was detected.Results During static cold storage,kidney ATPase activity gradually decreased,with LRS group showing the most significant decrease compared to TMP-LRS and HC-A groups at 6 h and later time points(P<0.01).There was no significant difference between TMP-LRS and HC-A groups at all time points(P>0.05).The kidneys showed mainly tubular swelling,tubular cell necrosis and shedding,interstitial edema,and endothelial cell necrosis,with changes becoming more obvious after 24 hours,and the LRS group showing the most significant changes.At the 24 h time point,there were significant differences among the three groups,and after 36 hours of perfusion preservation,the apoptosis level in the TMP-LRS group was lower than that in the HC-A group,but the difference was not significant.Conclusion The use of Lactate Ringer's solution containing Ligustrazine during organ procurement perfusion can achieve similar effects to those of HC-A solution,making it a potential substitute to reduce medical costs.

关 键 词：川穹嗪 灌注液 器官灌注 器官保存 

分 类 号：R69[医药卫生—泌尿科学]