细胞膜泵活性在急性肾衰竭致多器官损伤中的机制

Mechanism of multiple organ injury subsequent to acute renal failure with respect to membrane pump activity in rabbits

目的 观察急性肾衰竭（ARF）致多器官损伤家兔肾、心肌、胰腺细胞膜泵活性的变化,探讨ARF致多器官损伤的作用机制. 方法 将42只家兔按随机数字表法分为对照组、HgCl2组和甘油组,后两组再分为12、24、48 h 3个亚组,每组6只.以皮下注射1% HgCl2（1.3 ml/kg）或肌肉注射50%甘油（10 ml/kg）分别复制ARF模型.各组分别于不同时间点留取肾、心肌、胰腺组织并制备组织匀浆,采用定磷法检测上清液中的ATP酶活性. 结果 与对照组比较,两个ARF模型组肾组织匀浆Na＋-K＋-ATP酶、Ca2＋-ATP酶、Ca2＋-Mg2＋-ATP酶活性均随ARF病情程度加重而逐渐降低,于48 h达最低水平[HgCl2组分别为（0.84±0.16）、（0.52±0.17）、（0.45±0.09） μmol·mg-1·h-1,甘油组分别为（0.85±0.22）、（0.49±0.21）、（0.54±0.17） μmol·mg-1·h-1];心肌和胰腺组织匀浆Na＋-K＋-ATP酶、Ca2＋-ATP酶、Mg2＋-ATP酶、Ca2＋-Mg2＋-ATP酶活性也逐渐降低,48 h时达最低[心肌HgCl2组分别为（0.56±0.11）、（0.51±0.19）、（0.55±0.19）、（0.37±0.19） μmol·mg-1·h-1,甘油组分别为（0.52±0.19）、（0.62±0.10）、（0.61±0.16）、（0.54±0.10） μmol·mg-1·h-1;胰腺HgCl2组分别为（0.81±0.12）、（0.71±0.15）、（0.73±0.18）、（0.62±0.16） μmol·mg-1·h-1,甘油组分别为（0.72±0.13）、（0.57±0.18）、（0.66±0.14）、（0.59±0.23） μmol·mg-1·h-1],与对照组比较差异均有统计学意义（P〈0.05或P〈0.01）. 结论 ARF致心肌、胰腺损伤的机制与组织细胞膜泵活性降低有关.

Objective To observe the changes in membrane pump activity of kindey,myocardium and pancreas in rabbits with acute renal failure（ARF） in rabbits,and inquire into the mechanism of multiple organ injury subsequent to ARF. Methods Forty-two rabbits were randomly divided into control group,HgCl2 group and glycerine group,and the latter two groups were subdivided into 12,24,48-hour subgroups,with 6 rabbits in each group.The ARF model was reproduced by hypodermic injection 1% HgCl2（1.3 ml/kg） in HgCl2 group,or intramuscularly injection 50% glycerine（10 ml/kg） in glycerine group,respectively.At different time points,the kindey,myocardium and pancreas were harvested,and homogenates of them were prepared.The ATPase activities of different organ homogenates were determined. Results It showed that the activities of Na＋-K＋-ATPase,Ca2＋-ATPase,Ca2＋-Mg2＋-ATPase of renal homogenate in two model groups were reduced gradually with worsening of renal function,and they became lowest at 48 hours[（0.84±0.16）,（0.52±0.17）,（0.45±0.09） μmol·mg-1·h-1 in HgCl2 group;（0.85±0.22）,（0.49±0.21）,（0.54±0.17） μmol·mg-1·h-1 in glycerine group].The respective activities of Na＋-K＋-ATPase,Ca2＋-ATPase,Mg2＋-ATPase,Ca2＋-Mg2＋-ATPase of myocardium and pancreas homogenates in two model groups were reduced gradually following depression of renal function,and they became lowest at 48 hours[（0.56±0.11）,（0.51±0.19）,（0.55±0.19）,（0.37±0.19） μmol·mg-1·h-1 in HgCl2 group and（0.52±0.19）,（0.62±0.10）,（0.61±0.16）,（0.54±0.10） μmol·mg-1·h-1 in myocardium homogenate of glycerine group;（0.81±0.12）,（0.71±0.15）,（0.73±0.18）,（0.62±0.16） μmol·mg-1·h-1 in HgCl2 group and（0.72±0.13）,（0.57±0.18）,（0.66±0.14）,（0.59±0.23） μmol·mg-1·h-1 in pancreas homogenate of glycerine group],there was statistical difference compared with control group（P〈0.05 or P〈0.01）. Conclusion The mechanism of myocardial and pancreatic injury subsequent to ARF might be related to reduction of the activity of cell membrane pump.