丙泊酚对兔严重烫伤早期并发肾损伤时肾脏的保护作用

Protective Effect of Propofol on Renal Injury in Rabbits after Severe Scald Injury

目的探讨丙泊酚对兔严重烫伤早期并发肾损伤时肾脏的保护作用。方法取18只新西兰兔,构建30%体表总面积深度烫伤模型,随机分为烫伤对照组(S组)和丙泊酚麻醉组(P组)。P组烫伤后1 h开始静脉注射丙泊酚1mg/kg,然后以4 mg/(kg·h)的速率持续泵注3 h。S组以等容量的生理盐水替代丙泊酚。两组动物分别于烫伤前(T_0)、烫伤后4 h(T_1)、烫伤后8 h(T_2)、烫伤后12 h(T_3)、烫伤后24 h(T_4)采集血样,夹心酶联免疫吸附法测定血清TNF-α、IL-1、IL-6浓度;烫伤前、烫伤后6、12、24 h生化法测定尿素氮(BUN)和肌酐(Cr)含量;观察动物烫伤后24 h肾脏组织病理学变化。结果与T_0时点比较,两组T_(1~4)时点血清TNF-α、IL-1和IL-6浓度升高(P<0.05或P<0.01);P组经过丙泊酚处理后,T_(1~4)时点血清中TNF-α、IL-1和IL-6浓度比S组明显降低(P<0.05或P<0.01)。烫伤后血清BUN、Cr的含量明显高于烫伤前(P<0.05或P<0.01);P组烫伤后各时点血清BUN、Cr含量明显低于S组(P<0.05或P<0.01)。P组较S组肾脏病理学损伤程度减轻。结论丙泊酚对严重烫伤后肾脏功能受损和病理学改变有一定的缓解作用,这种保护机制很可能与丙泊酚抑制严重烫伤时IL-1、IL-6和TNF-α浓度升高相关。

Objective To investigate the protective effects of propofol during early stage of severe scald in rabbits with renal injury.Methods Eighteen New Zealand rabbits with severe scald injury（30%of total body surface area） were randomly divided into scald control group（S group）and propofol group（P group）.The rabbits of S group were injected with propofol 1 mg/kg 1 h after scald,followed by an infusion of 4 mg/（kg · h） for 3 h.The equal volume of normal saline was given in S group.Before scald（T0）and at 4 h（T1）,8 h（T2）,12 h（T3）,24 h（T4） after scald,serum samples were collected for detecting the TNF-α,IL-l,IL-6 levels using sandwich ELISA,BUN and Cr were measured by biochemicalmethods before and 6,12,24 h after the scald injury.The histological changes in the renal tissue of the rabbits in all groups were observed 24 h after scald.Results After scald,the serum levels of TNF-α,IL-1 and IL-6 began to significantly increase along with BUN and Cr levels（P〈0.05 or P〈0.01）.Compared with S group,the rabbits in P group showed lowered serum levels of TNF-α,IL-1 and IL-6 at T（1-4）（P〈0.05 or P〈0.01）.The serum BUN and Cr levels at different time points after scald were higher in S group than in the P group（P〈0.05 or P〈0.01）.The pathological alteration was slighter in the P group.Conclusion Propofol can provide protective effect on functionally and pathologically injured kidney in severely scalded rabbits.The protection mechanism is probably related with propofol inhibiting increase of TNF-α,IL-1 and IL-6 concentration.