摘要
目的探讨促红细胞生成素(EPO)对犬失血性休克(HS)代偿期肾功能的影响。方法 13只健康成年雄性犬随机分为对照组(n=3)、HS模型组(HS组,n=5)和EPO预处理组(EPO组,n=5)。采用股动脉放血复制HS犬模型,HS组犬休克60 min后采用醋酸钠林格液复苏;EPO组犬于术前1周内皮下注射重组促红细胞生成素注射液,150 IU·kg-1,每2 d 1次,共3次;对照组犬不行放血和复苏处理。连续监测血流动力学参数,检测不同时段血肌酐(SCr)、尿素氮(BUN)水平,苏木精-伊红染色后光镜下观察肾组织病理学改变,采用Paller评分法评估肾小管损伤程度。结果与对照组比较,在复苏各时间点,HS组犬SCr水平均明显升高(P<0.05),EPO组犬SCr水平无明显变化(P>0.05);与HS组比较,EPO组犬在复苏各时间点的SCr水平均下降(P<0.05)。与休克前比较,HS组、EPO组犬在复苏0 min(休克60 min)的BUN水平均升高(P<0.05),液体复苏后的其余时间点下降(P<0.05);HS组、EPO组犬分别在复苏30、60 min接近休克前的水平,并与对照组同时间点的BUN水平相当,组间比较差异无统计学意义(P>0.05)。与HS组比较,EPO组犬平均动脉压(MAP)恢复至≥90%休克前水平所需输液量更少(P<0.05)、时间更早(P<0.05)。对照组、HS组和EPO组犬肾小管Paller评分分别为5.83±2.28、19.48±3.26和6.13±2.11,EPO组犬肾小管Paller评分低于HS组(P<0.05)。结论 EPO能有效降低HS犬血清SCr水平,减轻肾脏病理损害,对犬HS代偿期的肾功能有一定保护作用。
Objective To study the effect of erythropoietin（ EPO） on kidney function during hemorrhagic shock（ HS）in dogs. Methods Thirteen healthy adult male dogs were divided randomly into control group（ n = 3）,HS model group（ HS group,n = 5）,pre-processing with EPO group（ EPO group,n = 5）. Hemorrhagic shock was induced by withdrawing blood from the femoral artery,the dogs in HS group were resuscitated with sodium acetate ringer＇s solution at 60 min after HS,while EPO group received a subcutaneous injection of recombinant human erythropoietin within one week before the operation（ 150 IU·kg-1,every two days,three times）,the dogs in control group did not be given bleeding and resuscitation. Hemodynamic parameters were continuously monitored; serum creatinine（ SCr） and blood urea nitrogen（ BUN） were tested at different time points. Histopathological changes of kidney tissues were observed by hematoxylin eosin（ HE） staining. The damage degree of the renal tubules was evaluated by Paller scoring method. Results Compared with control group,the SCr level in HS group at different time point after resuscitating rose more obviously（ P〈0. 05）,the SCr level in EPO group had no obvious change（ P〈0. 05）; compared with HS group,the SCr level in EPO group at different time point after resuscitating decreased more obviously（ P〈0. 05）. Compared with pre-HS,the BUN level in HS group,EPO group at 0 min after resuscitating（ 60 min after shock） rose more obviously（ P〈0. 05）,and decreased more obviously at other time point after resuscitating（ P〈0. 05）;the BUN level in HS group,EPO group at 60,30 min after resuscitating was very close to pre-HS level respectively and roughly equivalent to control group＇s level at the identical time points,through the detailed comparison among groups,the difference was no significant（ P〈0. 05）. Compared with HS group,mean arterial pressure（ MAP） of EPO group was recovered to preHS levels（ or ≥90%） with less solution（ P〈0. 05） and shorter time（ P〈0. 05）. Paller score of kidney tubules in control group,HS group and EPO group was 5. 83 ± 2. 28,19. 48 ± 3. 26 and 6. 13 ± 2. 11,respectively. Paller score of kidney tubules in EPO group was lower than in HS group（ P〈0. 05）. Conclusion EPO can effectively reduce the level of SCr,lessen pathological damage of kidney tissue and there is a protective effect for kidney during hemorrhagic shock in dogs.
出处
《新乡医学院学报》
CAS
2015年第3期220-223,共4页
Journal of Xinxiang Medical University
关键词
促红细胞生成素
失血性休克
急性肾损伤
血肌酐
尿素氮
erythropoietin
hemorrhagic shock
acute kidney injury
serum creatinine
blood urea nitrogen
