氯化汞与甘油制备家兔急性肾损伤模型的比较研究

Comparative Study on different establishment methods of rabbit model of acute kidney injury made by mercuric chloride and glycerin

目的比较分别用氯化汞与甘油制备家兔急性肾损伤（AKI）模型的肾功能及其形态学改变，初步探讨两者导致AKI机制的异同。方法1％氯化汞溶液0．25mL／kg耳缘静脉注射（H组）、50％甘油生理盐水15mL／kg腿部肌肉注射（G组）复制家兔AKI模型，造模前后分别取材测定其血肌酐、血尿素氮和尿蛋白等肾损伤标志物水平，随后取出肾脏计算肾系数，观察其大体及镜下改变，并进行肾损伤病理评分，比较各组造模后存活率、肾功能及形态学等差异。结果两组存活率差异无统计学意义（P〉0．02），血肌酐、血尿素氮和尿蛋白等肾损伤指标升高明显（P〈0．02），以血肌酐为标准，两组均达到AKI3期水平，但H组上述指标较G组显著（P〈0．02）。光镜下见H组近端小管病变严重，细胞坏死明显，蛋白管型〉80％；G组肾小管细胞肿胀明显，坏死少见，管型〈30％，且以红细胞管型为主。结论H组具有肾毒性AKI的典型表现，G组具有缺血性AKI的特征；两种造模方法分别针对AKI不同发病机制设计，有各自的应用价值。

Objective Compare the changes of renal function and renal morphology in two rabbit model of acute kidney fail made by mercuric chloride and glycerin, preliminarily discuss the the common points and differences of the AKI mechanism between the these two models. Methods The models were copied by intravenous injection 1% mercuric chloride （0. 25 mL/kg, H group ） and intramuscular injection 50% glycerin （15 mL/kg, G group）, the SCr, BUN and UPro were determined at 0 h and 40 h, blood pressure were measured as well. And then removed the kidneys, observed the changes of kidney pathology in the gross and through the microscope. Finally, observed and compared survival rate, function of kidney and morphological differences. Results The survival rate had no discrepancy （ P 〉 0. 02）. SCr, BUN and UPro were increased significantly （ P 〉 0.02）, which indicated that the two group both achieved AKI standards. The kidney pathology changes through the microscope revealed grievous proximal tubular lesions, the ceils necrosis, protein cast 〉 80% in the H group, however in the G group though the cells swelled badly, saw little of tubular lesions with cast 〈 30% （ mostly red cell cast）. Conclusion H group has the typical representation of toxic AKI, while G group has the character ischemic AKI. The two modeling methods are specially designed for the different mechanisms of AKI, which have their own application value.