肢体挤压时长与急性肾损伤关系的动物实验研究

Relationship between severity of acute kidney injury and time of compression： experiment with rats

目的探寻肢体在被挤压时间的长短与发生急性。肾损伤（AKI）严重程度的关系，为震后挤压伤的科学评估提供实验依据。方法24只大鼠随机均分为4组，双下肢被3kg压力分别挤压8h、16h、24h、48h，在挤压前，和解压后2h、6h、12h、24h：ff个时间点采血，检测血清中肌红蛋白（Mb）和肌酐（Cr），最后将大鼠处死取肾脏做病理切片并镜下观察，对各组肾脏病理损伤进行评分。用重复测量资料方差分析比较各组Mb及Cr总体水平的差异，用单因素方差分析比较各组病理损伤评分的差异。结果挤压16h组中的2只大鼠和挤压24h组的1只大鼠在解除压迫后24h内死亡；挤压16h组大鼠的Mb和cr总体水平均显著高于其他三组（均P〈O．05）；挤压8h、24h两组的Mb和cr总体水平均显著高于挤压48h组（均P〈0．05）。各组肾脏病理损伤评分两两比较的统计结果显示，挤压16h、24h两组病理损伤评分均显著高于其他两组（均P〈O．05），挤压16h组肾损伤评分显著高于挤压24h组（P〈0．05）。结论在相同的挤压部位及挤压重量下，肢体被挤压时间越长并不代表急性肾损伤程度越重。

Objective To explore the relationship between the severity of acute kidney injury （AKI） caused by crush injury and the time of compression upon limbs. Methods Twenty-four SD rats were randomly divided into 4 equal groups to undergo compression of 3 kg upon their both lower extremities for 8, 16, 24 and 48 hours respectively. Samples of heart blood were collected before compression and 2,6, 12, and 24 hours after decompression respectively to examine the serum myoglobin （Mb） and creatinine （Cr）. At last all the rats were killed with their kidneys taken out to undergo pathological examination so as to record the pathological scoring. One-way ANOVA was used to analyze the relationship between the severity of AKI caused by crush injury and the time of limbs undergoing compression. Results Two rats of the crushing 16h group and one rat of the crushing 24 h group died within 24 hours after decompression. The overall levels of Mb and Cr of the crushing 16 h group were both significantly higher than those of the other 3 groups （all P 〈0.05）. The overall levels of Mb and Cr of the crushing 8 h and 24 h groups were both significantly higher than that of the crushing 48 h group （all P 〈0.05）. The pathological scores of the crushing 16 h and 24 h groups were both significantly higher than those of the other 2 groups （all P 〈0.05）, and the pathological score of the crushing 16 h group was significantly higher than that of the drushing 24 h group （P 〈0.05）. Conclusion Under the same conditions of crushing weight and site being crushed, longer crushing time does not mean more severe AKI.