左西孟旦对心搏骤停-心肺复苏后大鼠肾损伤的影响

Effects of levosimendan on kidney injury in ventricular fibrillation-induced cardiac arrest rats

目的·探讨左西孟旦对心搏骤停-心肺复苏后大鼠肾损伤的影响。方法·将25只健康成年雄性SD大鼠随机分为左西孟旦干预组(L组,10只)、空白对照组(C组,10只)和假手术组(S组,5只)。L组和C组用心室纤颤(室颤)法建立心搏骤停–心肺复苏动物模型,L组大鼠在复苏期间及复苏后予左西孟旦干预,C组大鼠在复苏期间及复苏后予等剂量生理盐水处理。S组大鼠不进行心搏骤停和心肺复苏操作,予等剂量生理盐水处理。比较L组和C组大鼠在复苏后1、4、6 h的血清白细胞介素-6(interleukin-6,IL-6)、IL-10、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)、肌酐(creatinine,SCr)、尿素氮(blood urea nitrogen,BUN)、胱抑素C(cystatin-C,CysC)水平。复苏6 h后将3组大鼠处死留取肾脏组织,观察其病理损伤变化。结果·3组大鼠基线资料的差异无统计学意义。心肺复苏后,L组和C组大鼠血清炎症因子和肾功能指标较S组同期指标明显升高(均P<0.05)。复苏后1、4、6 h,L组血清炎症因子IL-6、TNF-α水平较C组降低(均P=0.000),IL-10水平较C组升高(P=0.000,P=0.002,P=0.036),差异均有统计学意义。复苏后1、4、6 h,L组肾功能指标SCr(P=0.001,P=0.007,P=0.472)、BUN(P=0.001,P=0.004,P=0.122)、CysC(P=0.493,P=0.001,P=0.175)较C组升高;但L组SCr、BUN指标仅在复苏后1、4 h与C组之间的差异有统计学意义,CysC指标仅在复苏后4 h与C组之间的差异有统计学意义。L组和C组大鼠肾组织病理表现均提示发生明显急性肾损伤,L组病理损伤程度轻于C组(均P=0.000)。结论·心搏骤停–心肺复苏后大鼠肾损伤明显,左西孟旦对其肾功能有明显保护作用。

Objective·To investigate the effects of levosimendan on kidney injury in the rat model of cardiopulmonary resuscitation.Methods·Twentyfive healthy adult male SD rats were randomly divided into three groups,which were sham group(S group,n=5),levosimendan group(L group,n=10)and control group(C group,n=10).Cardiac arrest and cardiopulmonary resuscitation procedure were created in L group and C group by inducing ventricular fibrillation.L group was treated with levosimendan during and after resuscitation,while C group and S group were given equivalent volume of saline solution.S group was not induced into cardiac arrest and resuscitation.Serum interleukin-6(IL-6),IL-10,tumor necrosis factor-α(TNF-α),creatinine(SCr),blood urea nitrogen(BUN)and cystatin-C(CysC)levels were compared between L group and C group at 1,4 and 6 h after resuscitation.Three groups of rats were sacrificed,and the pathological changes of kidney tissues were observed at 6 h after resuscitation.Results·All rats were resuscitated successfully.No differences were found between the three groups about baseline data.After resuscitation,compared with S group,the levels of serum inflammatory cytokines and kidney function indicators increased dramatically(all P<0.05)in the other two groups.In resuscitation after 1,4 and 6 h,the levels of IL-6 and TNF-αin L group were lower than those in C group,but IL-10 levels were higher in L group(P=0.000,P=0.002,P=0.036)than those in C group,and there were significant differences between the two groups(all P=0.000).In resuscitation after 1,4 and 6 h,the levels of SCr(P=0.001,P=0.007,P=0.472),BUN(P=0.001,P=0.004,P=0.122)and CysC(P=0.493,P=0.001,P=0.175)were lower in L group than those in C group.Only 1 and 4 hours after resuscitation,the differences in the levels of SCr and BUN were significant,and only 4 hours after resuscitation,the difference in the level of CysC was significant between L group and C group.Both L and C group showed pathological characteristics of severe acute kidney injury,and the pathological injury scores of L group were alleviated compared with those of C group(all P=0.000).Conclusion·Levosimendan can improve kidney injury of cardiac arrest and cardiopulmonary resuscitation model rats.