大鼠经皮肾穿刺造瘘模型中血清胱抑素C对肾损伤的评价

Evaluation of kidney injury using serum cystatin C in percutaneous nephrostomy model of rat

目的研究大鼠肾穿刺造瘘不同孔径、不同灌注压力下对肾脏造成的损伤时血清胱抑素C的变化,为临床评价经皮肾穿刺操作所致肾脏的损伤提供理论依据。方法健康雄性Wistar大鼠36只,随机分为A、B、C、D、E、F共6组,每组6只,A组(对照组)不穿刺不灌注,B-E组(穿刺灌注组)以不同穿刺孔径(0.7,1.6mm)、不同灌注压力(40、80cmH2O)(1cmH2O=0.098kPa)行肾脏穿刺灌注;F组(单肾组)术前行一侧肾脏切除后以1.6mm穿刺孔径、80cmH2O灌注压力行手术。于术后2、12和24h分别采血测定血清胱抑素C(CysC)、BUN、SCr变化情况,术后取肾组织行病理检查。结果同对照组相比,F组术后2hCysC与术前相比差异有显著性(P<0.05);术后12、24h血清CysC、BUN、SCr与术前相比变化差异均有显著性(术后12h,P<0.05;术后24h,P<0.01)。结论大鼠肾脏行穿刺灌注后可造成一定程度损伤且穿刺孔径越大,灌注压力越大,损伤越大;评价急性肾机械性损伤时,与SCr、BUN相比,CysC灵敏性更高。

【Objective】To explore the changes of serum cystatin C on kidney injury caused by different apertures,different perfusion pressure in percutaneous nephrostomy model of rat,and provide a theory basis for the evaluation of kidney injury caused by percutaneous nephrostomy in clinical practice.【Methods】Thirty-six male healthy Wistar rats were randomly divided into 6 groups as A,B,C,D,E and F as following（n=6）：group A（the control group） were neither punctured nor purfused;group B to E（purfused after punctured） were purfused using different pressure immediately after punctured by different apertures,the apertures are 0.7 and 1.6 mm,the perfusion pressure are 40 and 80 cmH2O（1 cmH2O =0.098 kPa）;group F（single kidney group） were removed their right kidney one week before punctured and purfused,the aperture is 1.6 mm,the perfusion pressure is 80 cmH2O.Blood samples were collected 2,12 and 24 h postoperation to detect Cys C,BUN and Scr.Pathology of the kidney were examined postoperation,too.【Results】Compared to the control group,Cys C increased significantly at 2 h postoperation（P〈0.05）.Cys C,BUN and Scr increased significantly at 12 and 24 h postoperation（12 h postoperation：P〈0.05,24 h postoperation：P〈0.01） in group F.【Conclusions】Puncture and purfusion can produce kidney injure in rat,and the bigger size of aperture,the higher of pressure,the more of renal function were damaged.Compared to Scr and BUN,Cys C is more sensitive when evaluating the acute mechanical kidney injury.