葛根素对创伤性休克家兔肾功能及超微结构的影响

Effect of puerarin(葛根素) on renal function and renal ultrastructural characteristics of rabbits with traumatic shock

目的探讨葛根素对创伤性休克家兔肾功能及超微结构的影响。方法将40只日本大耳白兔随机分成4组:假手术组、休克模型组、林格液复苏组和林格液加葛根素注射液治疗组,每组10只。制备创伤性休克模型,复苏组和治疗组均在休克1.5 h后予林格液进行复苏,而治疗组在复苏的同时静脉滴注葛根素注射液治疗。各组于休克前,休克后1.5 h和4 h采颈动脉血测定尿素氮(BUN)和肌酐(Cr),并于实验末处死白兔,取复苏组和治疗组肾组织作电镜标本,观察其超微结构的改变。结果家兔创伤性休克后血BUN和Cr值较休克前均显著升高,且休克后4 h的值较休克后1.5 h又有明显升高(P均<0.05)。复苏组休克后4 h的BUN值较休克组无明显降低(P>0.05),而Cr值明显低于休克组(P<0.05),但仍明显高于休克前和休克后1.5 h(P均<0.05)。治疗组休克后4 h的BUN和Cr值较休克组和复苏组均显著降低(P均<0.05),而且接近于休克前水平(P均>0.05)。电镜下可见复苏后家兔肾小球毛细血管内皮细胞肿胀,突向管腔;足细胞肿胀,有局灶性足突融合;胞浆内线粒体肿胀;肾小管上皮细胞以及胞浆内线粒体肿胀;内质网扩张;间质水肿。治疗组肾小球毛细血管内皮细胞无明显肿胀,内皮细胞无管腔内突起;足细胞正常,足突清晰无融合;肾小管上皮细胞无肿胀;线粒体结构基本正常;未见扩张的内质网。结论创伤性休克可导致家兔肾功能损害,葛根素能显著改善休克后家兔肾功能和保护肾组织。

Objective To investigate the effect of puerarin （葛根素）on renal function and renal ultrastructural characteristics of rabbits with traumatic shock. Methods Forty Japan white rabbits were randomly divided into four groups： sham operation, shock model, Ringer＇s solution and Ringer＇s solution plus puerarin groups （each, n=10）. After rabbits with traumatic shock for 1.5 hours, Ringer＇s solution was infused into the Ringer＇s solution group and puerarin group for resuscitation, and puerarin intravenous injection was given in the puerarin group during the course of resuscitation. Blood specimens were collected from each group at pre-shock and 1.5 and 4 hours after shock, and the concentrations of blood urea nitrogen （BUN） and creatinine （Cr） were measured. At the end of the test, the rabbits were sacrificed and the renal tissues of the Ringer＇s solution and the puerarin groups were obtained. The ultrastructural characteristics of the renal tissues were observed under electron microscope. Results The plasma concentrations of BUN and Cr of rabbits after shock were increased significantly contrasted with those at pre-shock, and those at 4 hours after shock were higher than those at 1.5 hours after shock （all P〈0.05）. Concentrations of BUN of the Ringer＇s solution group at 4 hours after shock was not significantly decreased in comparison with that of the shock group （P〉0.05）, while the concentrations of Cr of the Ringer＇s solution group at that point were decreased significantly （P〈0.05） contrasted with the shock group, however, the concentration of Cr of the Ringer＇s solution group at 4 hours after shock was still higher significantly （P〈0. 05） than that at pre-shock and 1.5 hours after shock in the same group. Concentrations of BUN and Cr at 4 hours after shock in the puerarin group were decreased significantly （both P〈0.05） contrasted with the shock group or the Ringer＇s solution group, and had no significant differences contrasted with those at pre-shock （P〉0.05）. Under electron microscope, in the Ringer＇s solution group, the glomerular capillary endotheliocytes were swelling and some of them protruded into capillary cavity; in their cytoplasm some mitochondria were swelling;podocytes were swelling and part of their processes were fused; renal tubule epithelial cells and most of their mitochondria were swelling; their endoplasmic reticula were expanded and mesenchyma was swelling. In the puerarin group, the glomerular capillary endotheliocytes were not significantly swelling, no protuberance of endotheliocytes in capillary cavity; podocytes were normal and no processes of podocyte were fused;the renal tubule epithelial ceils were not swelling, their mitochondria were nearly normal, and their endoplasmic reticula were not expanded. Conclusion Damage of renal function will happen to rabbits with traumatic shock. Puerarin can improve their renal function and protect their renal tissues.