脓毒症急性肾损伤的早期诊断及生大黄的疗效研究

Early diagnosis and therapeutic effect of rhubarb for septic acute kidney injury

目的探讨脓毒症急性肾损伤的早期诊断指标及生大黄对其的保护作用。方法将60只大鼠按随机数字表法分为模型组(A)、治疗组(B)和对照组(C)三组,每组20只。模型组腹膜内注射脂多糖5 mg/kg诱导建立AKI模型,治疗组在腹膜内注射脂多糖即刻胃管内注入生大黄粉溶液,对照组腹膜内注射等量生理盐水。三组大鼠分别在处理前即刻(基础值,0 h),处理后1、6、24 h测定尿Netrin-1及尿KIM-1含量,同时采集血样测定肌酐含量。结果大鼠注射脂多糖6 h后,血清肌酐及尿KIM-1水平开始明显上升,注射后1 h尿Netrin-1即有明显上升,6 h达到峰值,24 h左右逐渐下降;生大黄治疗组大鼠各时间点血清肌酐、尿Netrin-1及尿KIM-1上升程度均较模型组明显降低(P<0.05)。结论尿Netrin-1对脓毒症急性肾损伤有早期诊断作用,生大黄可降低脓毒症急性肾损伤大鼠Scr、尿Netrin-1及尿KIM-1水平,对肾脏有保护作用。

Objective To study early diagnostic index of septic acute kidney injury（AKI） and protective effect of rhubarb on septic AKI. Methods Sixty rats were randomly divided into the following 3 groups： model group （A）, treatment group （B） and control group （C）. Each group contains 20 rats. Rats from group A were received a intraperitoneal injection of lipopolysaccharide （LPS） at a dose of 5 mg/kg to induce AKI. Rats from group B were given rhubarb powder solution by oral administration immediately after LPS injection. Rats from group C were treated with the same volume of normal saline （NS） by intraperitoneal injection. Both serum level of creatinine （Scr） and urinary levels of Netrin-1 and KIM-1 of rats in 3 groups were detected in the different time points of treatment （0 h, 1 h, 6 h and 24 h）. Results The levels of KIM-I and CR in rats treated with LPS were obviously increased at the time point of 6 h （P〈O.05）. The urinary lev- el of Netrin-1 began to increase at the time point of 1 h and reached the highest level at the time point of 6 h, then gradually decreased at the time point of 24 h after the injection of LPS. In group B, the levels of Scr, Netrin-1 and KIM-1 were significantly lower as compared with group A （P〈0.05）. Conclusion The urinary level of Netrin-1 might has early diagnostic value in septic acute kidney injury. Rhubarb could protect the kidney of AKI model rats by de- creasing the serum level of Scr, urinary levels of Netrin-1 and KIM-1.