高原低氧应激对肾脏的影响

Stress damage of renal toleration when the organism exposed acutively at altitude hypoxia environment

目的观察高原不同海拔地区低氧应激对人和兔肾脏的影响。方法将平原兔12只随机分为4组，每组3只。A组为对照组，B、C、D组为平原兔在48h内直接迁饲到海拔4320m后1、7、30d组。E组为饲养在海拔2260m地区的高原兔（高原对照组），F组为海拔2260m高原兔24h内迁饲到4320m后1d。各组宰杀后行肾脏组织病理学观察。将进入高原2730m不同时间（G组〈6m，250人，H组2y，110人）的健康青年共350人行尿生化及尿微量蛋白检测，设平原健康青年100人为对照组（I组）。结果从平原急进4320m地区后兔肾脏的改变为肾小球毛细血管内皮细胞肿胀、变性、结构不清，间质内毛细血管明显充血，肾小管上皮细胞水样变性。G组和H组尿生化总阳性率28．9％，对照I组7％（P〈0．01），且G组32．8％％（82／250）高于H组25．0％（25／100，P〈0．01），d1微球蛋白G组（48．89±27．23）mg／L，H组（10．14±0．59）mg／L，均高于参考值5．86±4．50（P〈0．01）。结论从平原急进入高原地区可致肾小球和肾小管同时受损，表现为尿生化和尿微球蛋白检测阳性。当大气氧分压突然较大幅度降低时，不同大气压环境下生存的动物均可引起肾小球和肾小管应激性损害，其组织病理学改变基本相同。

Objective To explore the renal stresses damage and adaptation under different altitude hypoxia environment in which the health youngs and rabbits. Methods The study on rabbits renal histopathology in which the groups A （control group） ,B,C ,D were exposed to 4 320 m altitude 1,7,30 d from sea level. Another 6 rabbits were divided into group E （2260 m control group） and group F were exposed to 4320 m 24 h from 2260 m altitude. 450 health youngs were divided into groups G, staying altitude 〈6 months, 250 young; groups H, staying altitude 2 years, 100 youngs and groups I （sea level ）100 youngs, control group, the urine biochemical and albuminuria radioimmunoassay had been examined in the groups G and H, Only urine had been examined in the groups I. Results At altitude 4320 m, Rabbits renal histopathology：structural disturbance, degeneration angiectasis hyperemia of peritubular capillary and interstitial cell hydropic degeneration of renal tubular epithelial cell. Positive rate of urine biochemical： group G 32.8% was higher than group H 25.0% （ P 〈 0.01 ）. with group 17% （ P 〈 0.01 ）, α1-MG in group G （48.89 ±27.23） mg/L and group H （10.14 ±0.59） mg/L were higher than normal group （5.86 ± 4.50 ） mg/L （ P 〈 0.01 ）. Conclusion It can be induced early the injury of kidney in healthy youngs or rabbits at 4320 m altitude from sea level or 2260 m. The manifestation is albumnuria or 132-MG and α1-MG abnormal. The injury of renal tubular and glomerulus was synchronism,It can lead to irritability lesion of renal tubles and glomerular almost same When atmospheric pressure was descent suddenly at high altitude.