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论文摘要

连续性静脉-静脉血液滤过治疗山羊挤压综合征模型的建立

Continuous Veno-venous Hemofiltration in Goat Model with Crush Syndrome

作者:唐怡, 张凌, 杨莹莹等

Author:Tang Yi, ZHang Ling, Yang Ying-ying. et al

收稿日期:          年卷(期)页码:2016,47(1):28-32

期刊名称:四川大学学报(医学版)

Journal Name:JOURNAL OF SICHUAN UNIVERSITY (MEDICAL SCIENCE EDITION)

关键字:挤压综合征 山羊模型 急性肾损伤 连续性静脉-静脉血液滤过

Key words:Crush syndrome Goat model Acute kidney injury Continuous veno-venous hemofiltration

基金项目:

中文摘要

目的 建立山羊挤压综合征(CS)动物模型,并探讨连续性静脉-静脉血液滤过(CVVH)治疗对肾功能及肾组织病理变化的影响。方法 12只山羊随机分为对照组、CS模型组、CVVH治疗组,每组4只。CS模型组与CVVH治疗组山羊于后肢肌肉注射50%甘油生理盐水溶液10 mL/kg建立CS模型(对照组注射等量生理盐水),1、2、8、12、24 h后检测血清肌酸激酶(sCK)和血肌酐(sCr),以sCK>1 000 U/L,同时sCr>2倍对照值判断为造模成功。造模1 h后,CVVH治疗组于造模对侧股静脉留置单针双腔导管建立血管通路,采用智能化床旁肾脏替代治疗机进行CVVH治疗。血流量为100 mL/min,置换液流速为35 mL/(kg·h),以前稀释法输入,治疗23 h后(第24 h)处死动物,留取肾组织标本,光镜、电镜下观察肾组织病理组织结构变化;采用免疫组化染色检查caspase12蛋白表达变化及TUNEL染色对细胞凋亡进行检测。结果 造模山羊均于注射甘油后1 h内出现酱油色小便,尿量较对照组明显减少。CS模型组与CVVH治疗组造模1 h后血清sCr及sCK较对照组升高,差异有统计学意义(PPPP

英文摘要

Objective Crush syndrome (CS) is a common critical condition. This study aimed to establish a crush syndrome goat model through muscle injection of glycerol and test the effect of continuous veno-venous hemofiltraion (CVVH).Methods 12 male goats at 12-15 months age were randomly assigned into control, model, and CVVH groups. After 2 weeks of normal feeding, the goats were weighed and stripped off foods for 24 h. Goats in the model and CVVH groups were then injected with 50% glycerol athind legs. Diagnosis of CS was established based on serum creatine kinase (CK) >1 000 U/L and serum creatinine (sCr) > 2 times of standard. No intervention was given to goats in the control group. A catheter was planted to get blood access.CVVH was administered using a Prisma-flex machine, with blood flow being set at 100 mL/min and replacement fluid with pre-dilution at 35 mL/(kg·h). After 23 h of treatment, the goats were sacrificed.Plasma and kidney samples were taken.Results Bloody urine hyperkalemia and decrease of urine volume were found in all of the goats injected with glycerol.Serum CK and sCr increased 1 h after the injection compared with the controls. After 23 h of CVVH treatment, serum CK and sCr decreased compared with goats in the model group. The light microscope revealed manifestation of tubular necrosis and interstitial edema, but the glomeruli were almost normal. The electronic microscope found prominent signs of cell apoptosis, such as chromatin aggregation, mitochondrial swelling, and endoplasmic reticulum expansion. Caspase12 expression in the goats with CS was significantly higher than that in the controls. The CVVH treated goats had lower level of expression than those in the model group (P<0.05). TUNEL staining identified a higher proportion of renal cell apoptosis in the goats in the model group compared with those in the CVVH group.Conclusion Muscle injection with glycerol can induce CS in goats. Early CVVH intervention improves renal function and alleviates renal tubular cell apoptosis.

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