肾盂灌注冲洗并发全身炎症反应综合征猪模型的建立

Intrapelvic Perfusion of Systemic Inflammatory Response Syndrome in Pig models

目的:建立一种肾镜下肾盂灌注冲洗并发全身炎症反应综合征(SIRS)的猪模型。方法:家猪10头,随机分为假手术组和模型组,每组按时间点分为基础状态(Basic)、术后0h、术后6h、术后12h和术后24h 5个亚组。猪肾穿刺造瘘,利用自体盲肠内容物加入肾盂冲洗液中,模拟经皮肾镜取石术(PCNL)持续肾盂灌注冲洗1h。每个时间点观测肛温(T)、呼吸(RR)、心率(HR);采血行血细胞计数分析(WBC、RBC、PLT)、肾功能(Cr、BUN、β2-MG)测定、血清IL-6、IL-10、TNF-α含量测定;用光镜和电镜观察肾脏组织病理变化。结果:模型组在术后6 h-24 h各项指标与假手术组相比变化明显,差异有统计学意义(P<0.05或<0.01)。模型组肾脏组织光镜和电镜下观察病理切片均较假手术组有明显的形态学改变。结论:本模型较好地模拟了临床病人PCNL并发SIRS的病理生理过程,为进一步研究其发病机制和预防治疗具有重要意义。

Objective： To establish a model of intrapelvic perfusion of systemic inflammatory response syndrome（SIRS） in pigs.Methods： Ten pigs were randomly divided into sham group and model groups.Each group was further divided into five subgroups accord-ing to the time of preoperative（Basic）,postoperative 0 h,6 h,12 h and 24 h.The pigs was made a nephrostomy,and perfused the kidney with the perfusion fluid which was added to caecum content of pigs 1 hour.Rectal temperature（T）,respiratory rate（RR）,heart rate（HR）;Periph-eral blood cell counts（WBC,RBC,PLT）,renal function test（Cr,BUN,β2-MG）,and the serum levels of IL-6,IL-10 and TNF-α were record and analyzed;the pathological changes of kidney tissue were observed by optical microscope and electron microscopic.Results： Compared with that in the sham-operation group,the model-group each target change was obvious in postoperative 6h to 24 h（P 0.05 or 0.01）.Path-omorphology showed there was change in acute inflammatory.Conclusions： The model could simulate the pathophysiologic process of PCNL complicated with SIRS.It is important for us to further study the pathogenesis,prophylaxis and treatment of SIRS.