羟乙基淀粉(130/0.4)对大鼠肾脏缺血再灌注损伤的保护

Protective effects of hydroxyethyl starch(130/0.4)against ischemia reperfusion injury of kidney:experiment with rats

目的观察新一代羟乙基淀粉(130/0.4)对肾缺血再灌注损伤和免疫黏附分子(ICAM)-1表达的影响。方法建立大鼠肾缺血再灌注损伤模型,在缺血结束前开始输液治疗。随机分为假手术组(C 组)、生理盐水组(S 组)和羟乙基淀粉治疗组,每组10只。后者又按剂量分为 W1组(5 ml/kg)、W2组(10 ml/kg)和 W3组(20 ml/kg)。再灌注24 h 后对比肾功能、肾小管损伤(Paller评分法)和肾组织 ICAM-1表达。结果缺血再灌注后肾功能受损,肾小管损伤评分 S 组43.2±15.8,W2和 W3组损伤明显较轻(分别为33.6±16.6和29.2±12.3,P<0.05)。ICAM-1吸光度值 S组213±32,W2和 W3组表达较少(分别为182±22和161±25,P<0.01)。但 W1组与 S 组差别不显著。结论输注10～20 ml/kg 羟乙基淀粉(130/0.4)可以明显减轻大鼠肾缺血再灌注损伤。抑制ICAM-1表达和活性是其可能的机制之一。

Objective To explore the protective effects of hydroxyethyl starch （HES） （130/0.4） against ischemia reperfusion injury of kidney and its impact on the expression of intercellular adhesion molecule-1 （ ICAM-1 ）. Methods Forty SD rats underwent resection of the right kidney and clamping of the left renal artery for 60 min to establish renal ischemia reperfusion model, and then were randomly divided into 4 equal groups ： Group S, undergoing infusion of normal saline 20 mg/kg 20 min before the reopening of the renal artery, Group W1, undergoing infusion of HES 5 mg/kg 20 min before the reopening of the renal artery, Group W2, undergoing infusion of HES 10 mg/kg, and Group W3, undergoing infusion of normal saline 20 mg/kg. Ten rats underwent sham operation and were used as controls （ Group C）. 24 h after reperfusion arterial blood samples were collected to detect 6 the levels of serum creatinine （Cr） and blood urea nitrogen （BUN）, and then the rats were killed with their kidneys taken out to undergo pathological examination and calculation of Paller＇s score. Immunohistochemistry was used to detect the expression of intercellular adhesion molecule-1 （ ICAM-1 ）. Results The levels of BUN and Cr of Group S were 152 ± 22 and 3.17 ± 1.00 mmol/L respectively, both significantly higher than those of Group C, and the levels of BUN and Cr of Groups W2 and W3 were 99 ± 23 and 1.82 ± 0. 86 mmol/L and 92 ± 28 and 1.57 ± 0.70 mmol/L respectively, all significantly lower than those of Group S （ P 〈 0. 05 or P 〈 0.01 ）. The Paller＇s scores of W2 and W3 were 33.6 ± 16.6 and 29.2 ± 12.3 respectively, both significantly lower that of Group S （43.2 ± 15.8, both P 〈 0.05 ）. The absorption levels of ICAM-1 of Groups W2 and W3 were 182±22 and 161 ±25 respectively, both significantly lower than that of Group S （212 ± 32, P 〈 0.01 ）. Conclusion Infusion of 10 N 20 ml/kg HES （130/0.4） significantly alleviates the ischemia-reperfusion injury, probably by reducing the ICAM-1 expression.