造影剂对大鼠肾脏氧化应激状态的影响及可能意义

Effect of contrast medium induced nephropathy on oxidative stress of rat kidney and its potential significance

目的探讨不同造影剂对大鼠肾脏氧化应激状态的影响及可能意义。方法将24只雌性SD大鼠分为正常对照组（c组）及造影剂肾病（CIN）模型组[高渗离子型造影剂复方泛影葡胺组（HOCM组）、低渗非离子型造影剂优维显组（LOCM组）和等渗非离子型造影剂碘克沙醇组（IOCM组）]。所有大鼠均在注射造影剂后24h杀检。采用常规病理组织检查观察肾脏病理改变，TUNEL染色检测肾小管上皮细胞凋亡。同时检测肾脏氧化应激指标丙二醛（MDA）、过氧化氢（H2O2）、超氧阴离子歧化酶（SOD）、总抗氧化活性（TAOC）、过氧化氢酶（CAT）。结果建模后24h与C组比较，HOCM、LOCM和IOCM组肾小管坏死、肾小管上皮细胞凋亡、肾髓质瘀血均显著升高（P〈0．05），但肾脏病理改变以HOCM组最为显著，IOCM组最轻。与C组相比，HOCM、LOCM和IOCM组肾MDA显著升高（P〈0．05），而HOCM、LOCM组肾TAOC显著降低（P〈0．05）；与IOCM组相比，HOCM、LOCM组肾MDA明显升高（P〈0．05）；HOCM组肾H2O2分别较C组、LOCM和IOCM组显著升高（P〈0．05）；但SOD、CAT在各组大鼠差异无统计学意义（P〉0．05）。结论大鼠造影剂肾病时肾脏氧化应激显著增强，氧化应激可能参与CIN发病，造影剂肾毒性大小可能与其对肾脏氧化应激影响程度有关。

Objective To study the influence and significance of different contrast agents on oxidative stress in rat kidney. Methods Twenty - four female SD rats were divided into four groups （ n = 6/ group）, normal control group （ group C ）, high - osmotic contrast media megluminc diatrizoate （ group HOCM）, low -osmotic contrast media iopromide （group LOCM） and isosmotic nonionic contrast media iodixanol （group IOCM）. All rats were killed 24 h after injection of contrast agents. The kidney injury was assessed by hematoxylin and eosin staining. Apoptosis of tubular epithelial cells was detected by TUNEL staining. Simultaneously, kidney malondialdehyde （MDA） , hydrogen peroxide （ H2 02 ） , superoxidedismutase （ SOD）, total antioxidant activity （ TAOC ）, catalase （CAT） and glutathione （ GSH ） were detected to evaluate oxidative stress in kidney. Results Twenty - four hours after injection of con- trast media, compared with control group, kidney tubular epithelial cell necrosis and apoptosis, congestion of kidney medulla were significantly increased in HOCM, LOCM and IOCM groups （P 〈 0.05 ）. Pathological changes of kidneys were the most serious in HOCM group. Kidney MDA was significantly increased in HOCM, LOCM and IOCM groups than that in control group （P 〈 0. 05） , while kidney TAOC was significantly decreased in HOCM, LOCM groups than in control group （P 〈 0.05）. Compared with IOCM group, kidney MDA was significantly increased in HOCM and LOCM groups （P 〈 0. 05）. Kidney H202 was increased in HOCM group compared with other groups respectively （P 〈 0. 05）. But kidney SOD and CAT had no significant difference between the four groups （P 〉 0.05 ）. Conclusions Oxida- tive stress is enhanced in rat kidney of contrast medium induced nephropathy（CIN） and it may play an important role in the pathogenesis of CIN. The renal toxicity of contrast medium with different physicaland chemical its impact on stress properhes may the degree of be relevant with kidney oxidative