生物人工肾小管构建及其对ARF-MODS猪血清IL-6、TNF-α、IL-10的影响

Construction of bioartificial renal tubule assist device and effect of this device on serum interleukin-6,tumor necrosis factor-α and interleukin-10 in pigs with multiple organ dysfunction syndrome and acute renal failure

目的构建生物人工肾小管装置(RAD),观察其对急性肾衰竭并多器官功能障碍综合征(ARF-MODS)猪炎症过程的影响。方法采用猪肾近曲小管细胞,以滤器AV-400S作支撑,构建RAD。用双肾肾动脉钳闭法加盲肠结扎、穿孔法制作ARF-MODS猪模型,随机分为连续性血液滤过(CVVH)治疗组(n=6)和CVVH+RAD治疗组(n=6),观察其生存时间,并分别于治疗开始时、治疗12h和治疗24h等时点取血标本检测血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)浓度。结果①抽样检测RAD,其菊粉复原率为(0.965±0.027),显微镜下显示肾小管上皮细胞基本覆盖了空心纤维内壁;②CVVH+RAD组与CVVH组生存时间分别为(36.82±10.78)h,(28.46±9.82)h,前者明显长于后者(P<0.05);③CVVH+RAD组与CVVH组治疗24h时血清IL-10浓度较同组治疗前升高(P<0.05),其上升幅度前者显著高于后者(P<0.05);二组治疗24h时血清IL-6、TNF-α浓度较同组治疗前均有下降(P<0.05),但二组间比较无显著差异。结论CVVH+RAD治疗ARF-MODS疗效优于单纯CVVH治疗;CVVH+RAD可提升抗炎因子IL-10水平,改善致炎-抗炎因子间的平衡,这可能是RAD治疗ARF-MODS的机制之一。

Object To construct bioartificial renal tubule assist device (RAD) and to investigate the effect of this device on inflammation processes in pigs suffering from multiple organ dysfunction syndrome and acute renal failure (ARF-MODS). Method The bioartificial renal tubule assist device was fabricated using porcine renal proximal tubule cells growing in an AV-400S hemofilter. ARF-MODS pigs (n=20) were induced by incarceration of bilateral renal arteries,ligation and perforation of cecum. The animals were then ...