去甲肾上腺素减轻非控制性失血性休克复苏后大鼠肾脏损伤

Norepinephrine alleviates renal injury after resuscitation in a rat model of uncontrolled hemorrhagic shock

目的探讨去甲肾上腺素对非控制性失血性休克复苏后大鼠肾脏损伤的影响。方法建立非控制性失血性休克复苏大鼠模型,将模型大鼠随机分为3组:假手术组、乳酸林格液(LR)组和去甲肾上腺素(NE)组。休克180 min,观察并记录各组大鼠的血流动力学变化(平均动脉压,MAP)。复苏时NE组以10μg/(kg.min)泵注NE;LR组泵注等量的乳酸林格液。同时,两组在70 min内回输40 ml/kg的乳酸林格液及半量失血。复苏结束后再观察20 min,取血液标本检测尿素氮(BUN)及肌酐(Cr)。复苏后24 h,观察大鼠生存率并取左肾做病理检测。结果 NE组血清BUN、Cr值较LR组下降,差异有统计学意义(P<0.05);24 h生存率高于LR组,差异有统计学意义(P<0.05)。结论在保证血容量的情况下,非控制性失血性休克的复苏过程中使用NE较单纯乳酸林格液复苏可减轻大鼠肾脏损伤,提高生存率。

Objective To investigate the effect of norepinephrine on renal injury after resuscitation in a rat model of uncontrolled hemorrhagic shock.Methods Rat model of uncontrolled hemorrhagic shock was established and the model rats were randomly divided into 3 groups,namely,the Sham-operation group,the lactated Ringer’s solution（LR） group,and norepinephrine（NE） group.The mean artery pressure（MAP） were observed in each group 180 min after shock.During resuscitation animals in NE group received norepinephrine（10 μg/[kg·min]）;the LR group received the same volume of lactated Ringer’s solution.During 70 min resuscitation,lactated Ringer’s solution（40 ml/kg） and half of the shed blood were transfused into animals in NE group and LR group.The blood samples was collected 20 min following half shed blood transfusion for measuring blood urea nitrogen（BUN） and creatinine（Cr）.The survival rates were observed 24 h after the resuscitation and the left kidney was evaluated pathologically.Results The serum levels of BUN and Cr in NE group were significantly lower than those in the LR group（P〈0.05）.And the 24 h survival rate of NE group was significantly higher than that of the LR group（P〈0.05）.Conclusion Norepinephrine,compared with lactated Ringer’s solution alone,can attenuate renal injury and improve the survival rate of rat models of uncontrolled hemorrhagic shock and resuscitation.