前列地尔预防对比剂肾病的实验研究

The protection of prostaglandin E1 against contrast-induced nephropathy:an experimental study

目的观察注射用前列地尔干乳剂(优帝尔)对对比剂肾病(contrast-induced nephropathy,CIN)的预防作用。方法选择日本大耳白兔40只,随机分成对照组和实验组,每组20只。对照组通过股动脉插管后经介入导管注射对比剂(优维显370)3 g/kg,实验组术前30 min及术后6 h、12 h经耳缘静脉给予前列地尔0.5μg/kg,并注射对比剂(优维显370)3 g/kg。分别在术前30 min及术后24 h、48 h查动物血清肌酐和尿素氮。术后72 h取动物右侧肾脏进行病理学检查。结果两组动物在注入对比剂24 h后血清肌酐均有上升,与注入前比较差异有统计学意义(P<0.05);实验组上升水平低于对照组,两组间差异有统计学意义(P<0.05)。注射对比剂24 h后,对照组发生CIN 6只(30%),实验组1只(5%),组间差异有统计学意义(P<0.05)。实验组光镜下病理形态学改变较对照组不明显,两组间差异有统计学意义(P<0.05)。结论前列地尔干乳剂能降低注射对比剂后血清肌酐的上升水平和CIN的发生率,具有保护肾脏的作用。

Objective To investigate the effect of prostaglandin El （PGE1） on the prevention of contrast-induced nephropathy （CIN） in experimental rabbits. Methods A total of 40 Japanese rabbits were randomly and equally divided into study group and control group. After catheterization through femoral artery, contrast agent （3 g/kg plus 10 ml normal saline） was infused through catheter in the rabbits of the control group. For rabbits of the study group, intravenous administration of PGEI （0.5 ug/kg plus 10 ml normal saline） via ear- margin veins was carried out each time at 30 minutes before operation and 6, 12 hours after operation, and contrast agent （3 g/kg） was also infused through catheter. The serum creatinine and urea nitrogen levels were determined at 30 minutes before operation and 24, 48 hours after operation. At 72 hours after the operation, the fight kidneys of the animals were removed and sent for pathologic examination. The results were analyzed. Results At 24 hours after the injection of contrast agent, an obvious increase in serum creatinine was seen in the animals of the both groups, and the difference in serum creatinine was statistically significant when compared with that determined before the use of contrast agent （P 〈 0.05）. The increase in serum creatinine of the study group was significantly lower than that of control group （P 〈 0.05）. At 24 hours after the injection of contrast agent, CIN occurred in 6 rabbits of the control group （30%） and in one rabbit of the study group （5%）, and significant difference in the occurrence of CIN existed between the two groups. Optical microscopic examination showed that pathologic changes in the rabbits of the study group were less obvious than those in the rabbits of the control group （P 〈 0.05）. Conclusion PGE1 can effectively suppress the increasing degree of serum ereatinine after the injection of contrast agent, and reduce the occurrence of CIN, therefore. PGE1 has the 9rotective effect for renal funetion.