尿激酶对大鼠重症急性胰腺炎并发肾脏损伤的影响

Effect of Urokinase on Severity Acute Pancreatitis with Renal Injury in Rat

目的探讨重症急性胰腺炎(SAP)时肾脏微循环障碍对肾脏损伤的影响及尿激酶对其的保护作用。方法将192只Wistar大鼠随机均分为正常对照组、SAP组和尿激酶组,各组再分为2、6、12及24 h亚组,每组16只。其中8只用于测定肾脏血流量,另8只用于抽取血样和进行组织病理学检查。将5%牛磺胆酸钠经十二指乳头逆行注入胰胆管内制备SAP大鼠模型。采用放射性生物微球技术测定各组大鼠的肾脏血流量,采用相应试剂盒检测血浆血栓素B2(TXB2)和6-酮-前列环素F1α(6-Keto-PGF1α)水平,采用HE染色法观察肾脏组织的病理组织学改变。结果与正常对照组比较,各时相SAP组和尿激酶组大鼠的肾脏血流量均较低(P<0.05),TXB2/6-Keto-PGF1α的活性比值均较高(P<0.01),且SAP组大鼠肾脏组织的病理学损伤程度较重(P<0.01)。与SAP组比较,尿激酶组大鼠2、6及12 h的肾脏血流量较高(P<0.01),各时相TXB2/6-Keto-PGF1α的活性比值均较低(P<0.01),且组织病理学损伤均较SAP组减轻(P<0.05)。结论 SAP大鼠肾脏微循环血流量减少及相关炎症介质水平的升高是SAP早期肾脏损伤的重要原因。尿激酶对SAP肾脏损伤具有保护作用。

Objective To explore the effect of renal microcirculation following severity acute pancreatitis（SAP） on renal injury and to explore the protection effect of urokinase on them.Methods A total of 192 Wistar rats were randomized divided into normal control group,SAP group,and urokinase group,then rats of 3 groups were sub-divided into 2,6,12,and 24 hours group,each group enrolled 16 rats.Of the 16 rats in each subgroup,8 rats underwent blood flow of renal test,other 8 rats were sacrificed to get blood samples and to perform histopathological examination.The rat models of SAP were established by retrograde injecting with 5% sodium taurocholate into the cholangiopancreatic duct.Radioactive biomicrosphere technique was used to measure the blood flow of renal,levels of plasma thromboxane B2（TXB2）and 6-keto-prostaglandin F1α（6-Keto-PGF1α）were tested by the TXB2kit and 6-Keto-PGF1α kit,and histopathological changes of renal tissues were observed by using HE staining.Results Compared with normal control group at the same time point,the blood flow of renal were lower（P0.05）,activity ratio of TXB2to 6-Keto-PGF1α were higher（P0.01）,and the histopathological injury were worse（P0.01）in rats of SAP group and urokinase group.Compared with SAP group,the blood flow of renal at 2,6,and 12 hours in urokinase group were higher（P0.01）,the activity ratios of TXB2 to 6-Keto-PGF1α were lower（P0.01）,and the histopathological injury were lighter（P0.05）in all the 4 time points of urokinase group.Conclusions The renal microcirculation dysfunction and increase of activity ratio of TXB2to 6-Keto-PGF1α may play an important role in renal injury following SAP in early stage.Urokinase can protect the renal from such injuries.