高渗氯化钠羟乙基淀粉溶液对重度失血性休克大鼠肾脏的影响

Effects of hypertonic sodium chloride hydroxyethyl starch on kidney injury in rats with severe hemorrhagic shock

目的观察高渗氯化钠羟乙基淀粉溶液(hypertonic sodium chloride hydroxyethyl starch,HSH)对重度失血性休克大鼠肾脏再灌注损伤的影响。方法雄性SD大鼠48只随机分为4组,分别为正常对照组(N组)、单纯休克组(NR组)、乳酸林格液复苏组(LR组)及HSH复苏组(HSH组),每组12只。采用改良Wigger’s法复制失血性休克动物模型,分别于休克前(Ts)、处死前(Td)取静脉血检测尿素氮(BUN)及肌酐(Cr)含量。NR组在休克后1 h即刻、其余组在复苏后4 h处死大鼠取肾组织测定细胞间黏附分子1(ICM-1)表达,光镜下观察各组大鼠肾组织病理变化并比较肾小管损伤(Paller评分)程度。结果与N组比较,NR组、LR组和HSH组Td时间点静脉血中BUN及Cr水平均升高(P<0.05);肾组织ICM-1表达增加(P<0.05),肾小管Paller评分升高(P<0.05),肾组织病理学损伤明显。与LR组比较,HSH组ICM-1表达减少,Paller评分降低,差异有统计学意义(P<0.05),且肾组织病理学损伤较轻。结论与LR相比,HSH液体复苏能减轻对重度失血性休克大鼠肾脏的再灌注损伤。

Objective To observe the effects of hypertonic sodium chloride hydroxyethyl starch （HSH） on kidney injury in rats with severe hemorrhagic shock. Methods 48 male SD rats were randomly divided into 4 groups, 12 rats each： the normal control group （group N）, no resuscitation group （group NR）, LR-treated group （group LR）, and HSH-treated group （group HSH）, the model of severe hemorrhagic shock in rats were established by using the modified Wigger＇ s method. Blood specimens were respectively collected at the time of before shock （Ts） and before killed （Td） to detect the content of urea nitrogen （BUN） and creatinine （Cr）. 1 hour after shock in group NR and 4 hours after resuscitation in group N, LR and HSH, rats were killed and the kidneys were collect- ed to determine the expression of intercellular adhesion molecule 1 （ ICM-1 ）. The pathologic injury and the Pallet＇ s score of kidneys were observed by light microscope. Results Compared with group N , at the time of before killed （Td） the BUN and Cr levels in group NR, LR and HSH were higher （ P 〈 0.05 ） ; The ICM-1 expression in kidney were increased （ P 〈 0.05 ） , the paller＇ s score were rised （P 〈 0.05）, and pathological injuries in kidney tissue were obvious. Compared with group LR, the indexes of ICM-1 ex- pression and the paller＇ s score in group HSH were lower, the differenee were statistically significant （P 〈 0.05 ）. And pathological in- juryies in kieney tissue were also slight. Conclusions Compared with group LR, HSH resuscitation can release the kidney reperfusion injury in rats with severe hemorrhagic shock.