右美托咪定对小鼠肾脏缺血再灌注肾小管和微循环损伤的机制和影响  

Mechanism and effect of Dexmedetomidine on renal tubule and microcirculation injury during renal ischemia reperfusion in mice

作　　者：赵伟新 夏贵山 李正凯 金小高 ZHAO Wei-xin;XIA Gui-shan;LI Zheng-kai;JIN Xiao-gao(Department of Anesthesiology and Perioperative Medicine,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属郑州中心医院麻醉与围术期医学科,郑州450000

出　　处：《医药论坛杂志》2024年第7期679-683,共5页Journal of Medical Forum

基　　金：河南省重点研发与推广专项(222102310019);河南省医学科技攻关省部重点项目(SBGJ202102209);郑州市中心医院科研启动基金项目(KYQDJJ2021005)。

摘　　要：目的探讨右美托咪定(DEX)对小鼠肾脏缺血再灌注(I/R)肾小管和微循环损伤的机制和影响。方法将雄性C57BL/6小鼠分为对照组、I/R组、DEX组和I/R-DEX组各10只;对照组不进行任何处理;I/R组用血管钳将左肾动静脉夹闭40 min后再灌注3 h;DEX组输注10μg/kg盐酸右美托咪定;I/R-DEX组在缺血开始时输注10μg/kg盐酸右美托咪定后同I/R组处理。比较4组氧化状态参数、肾功能参数、肾脏氧合变量和组织学表现。结果I/R组超氧化物歧化酶(SOD)、过氧化氢酶(CAT)和谷胱甘肽(GSH),以及肾皮质(CμPO_(2))、外髓质(MμPO_(2))和肾静脉(PrvO_(2))微血管氧张力低于对照组和DEX组,I/R-DEX组上述氧化状态参数和肾脏氧合变量低于对照组和DEX组,但高于I/R组。I/R组丙二醛(MDA),血尿素氮(BUN)、血清肌酐(Scr)、肿瘤坏死因子α(TNF-α)和胱抑素C(Cys C),以及组织学损伤评分高于对照组和DEX组,I/R-DEX组上述肾功能参数和组织学损伤评分高于对照组和DEX组,但低于I/R组。镜下I/R组可观察到广泛的间质出血,皮质损伤,肾小球细胞减少和萎缩,皮质小管出现上皮细胞脱落,I/R-DEX组肾小球形态正常,小管和间质区显示轻微变性。结论缺血开始时输注10μg/kg DEX可改善小鼠氧化状态、微循环状态和I/R相关的肾损伤,对肾脏缺血再灌注具有保护作用。Objective To investigate the mechanism and effect of Dexmedetomidine(DEX)on renal tubule and microcirculation injury during renal ischemia reperfusion(I/R)in mice.Methods Male C57BL/6 mice were divided into control group,I/R group,DEX group and I/R-DEX group with 10 mice each.The control group did not receive any treatment;In I/R group,the left renal arteriovenous was clamped for 40 min and then reperfusion was performed for 3 h.DEX group was given 10μg/kg Dexmedetomidine hydrochloride.The I/R-DEX group was treated with the I/R group after infusion of 10μg/kg Dexmedetomidine hydrochloride at the onset of ischemia.The oxidation status parameters,renal function parameters,renal oxygenation variables and histological findings of the 4 groups were compared.Results SOD,CAT and GSH,as well as CμPO_(2),MμPO_(2) and PrvO_(2) in I/R group were lower than those of control group and DEX group,the above oxidation state parameters and kidney oxygenation variables in I/R-DEX group were lower than those of control group and DEX group,but higher than those of I/R group.MDA,BUN,Scr,TNF-α,Cys C and histological injury score in I/R group were higher than those of control group and DEX group,and those of I/R-DEX group were higher than those of control group and DEX group,but lower than those of I/R group.Microscopically,I/R group showed extensive interstitial bleeding,cortical injury,glomerular cell reduction and epithelial cell shedding in atrophic cortical tubules,while I/R-DEX group showed normal glomerular morphology and slight degeneration in tubule and interstitial area.Conclusion Infusion of 10μg/kg DEX at the beginning of ischemia can improve the oxidative status,microcirculation status and I/R-related renal injury in mice,and has a protective effect on renal ischemia-reperfusion.

关 键 词：右美托咪定 缺血再灌注 微循环 肾脏 

分 类 号：R614[医药卫生—麻醉学]