不同灌注液对体外灌流兔肾功能和形态的影响  

Effect of different perfusion liquids on the perfused rabbit kidney

作　　者：袁发焕[1] 程燕[2] 

机构地区：[1]第三军医大学附属新桥医院肾内科,全军肾脏病中心,重庆市肾脏病研究所,重庆400037 [2]解放军第252医院内科,保定071000

出　　处：《第三军医大学学报》2003年第8期708-711,共4页Journal of Third Military Medical University

基　　金：重庆市科委应用基础基金资助项目 ( 1997)

摘　　要：目的　观察不同灌注液对体外灌流肾脏灌流量的影响 ,为建立体外灌流保存肾脏的技术平台做准备。方法45只健康成年新西兰白兔 ,无菌条件下取其左肾进行灌流 ,根据灌流液的不同 ,分为A(肝素抗凝自体全血 )、B(肝素抗凝自体血 +等量RPMI 164 0培养基 )、C(异体洗涤红细胞 +去纤维蛋白血浆 +等量RPMI 164 0培养基 ) 3组 ,每组 15只 ,3只用于观察最长灌流时间 ,12只用于观察其它指标。以 10 0mmHg灌注压 (酚妥拉明解痉 )灌流 ,测定 0、2 4、48、60h肾重量、肾静脉流出液乳酸脱氢酶 (LDH)活性、尿pH值、尿钠和尿钾的浓度变化 ,及肾组织的光镜及透射电镜病理变化。结果　C组肾脏灌流时间最长 ( >72h) ,肾脏重量增加值最低 (P <0 .0l) ,乳酸脱氢酶活性增加值最低 (P <0 .0l) ,尿pH增加值最低(P <0 .0 5 ) ,尿钠浓度增加幅度和尿钾浓度下降幅度最小 (P <0 .0 5 ) ,光镜及电镜下C组形态学损害最轻。结论　C组灌流液用于肾脏灌流保存 ,能改善肾脏功能 。Objective To observe the effect of different perfusion liquids on the perfused kidney to establish a method for preserving kidneys in vitro by perfusion in the future. Methods A total of 45 healthy adult New Zealand White rabbits were randomly divided into 3 groups according to different perfusion media with 15 left kidneys in each group: Group A, heparin anticoagulated blood, Group B, heparin anticoagulated blood diluted with equal volume of RPMI 1640 culture medium substrate, Group C, saline washed erythrocyte plus fibrin free plasma diluted with equal volume of RPMI 1640 culture medium substrate. In each group, 3 kidneys were used to observe the longest perfusion time, but other 12 kidneys were used for the observation of the renal weight, activity of lactate dehydreogenase in out flow liquid from renal vein, urine pH value, changes of urine natrium and potassium in 0, 24, 48, 60 h after perfusion at the perfusion pressure of 100 mmHg. At the same time, renal histology was also observed microscopically and trans electron microscopically. Results Group C had the longest perfusion time (>72 h), the lowest increase of kidney weight ( P <0.01), LDH activity ( P <0.01) and urine pH ( P <0.05), the least decrease of urine sodium and urine potassium ( P <0.05), and the lightest renal histological lesion. Conclusion The mixed perfusion liquid has advantages in improving the function of perfused kidney and prolonging the perfusion preservation time.

关 键 词：肾脏 灌流 保存 

分 类 号：R654.1[医药卫生—外科学] R692[医药卫生—临床医学]