不同晶体液复苏对脓毒症大鼠肾脏结构及其功能的影响

Effects of different crystalloid fluids resuscitation on renal structure and function in sepsis rats

比较生理盐水与钠钾钙镁葡萄糖注射液复苏对脓毒症大鼠肾脏结构及功能的影响。将大鼠按随机数字表分为对照组、脓毒症模型组、生理盐水复苏组、钠钾钙镁葡萄糖液复苏组,盲肠结扎穿孔法建立脓毒症大鼠模型,通过颈静脉泵入不同晶体液复苏,复苏结束时行动脉血气分析,复苏后72 h处死大鼠,测血浆尿素氮、肌酐、白细胞介素(IL)-1β、IL-6、肿瘤坏死因子α(TNFα)水平。留取肾组织,评估肾损伤程度,免疫组化检测大鼠肾组织Caspase-3表达。结果显示,与生理盐水复苏组比,钠钾钙镁葡萄糖液复苏组大鼠血浆Cl-、尿素氮、肌酐、IL-1β、IL-6和TNFα水平显著降低(P<0.05),肾组织Caspase-3表达显著减少(P<0.05),肾损伤评分显著降低(P<0.05)。钠钾钙镁葡萄糖注射液复苏能够明显改善脓毒症大鼠肾功能,减轻肾脏病理损害程度。

To evaluate the effects of resuscitation with normal saline and sodium potassium magnesium calcium and glucose injection on renal structure and function in septic rats.Rat model of sepsis was established by ligation and perforation of cecum.Male SD rats were divided into four groups:sham operation group,sepsis group,saline resuscitation group,sodium potassium magnesium calcium and glucose injection resuscitation group.Blood gas analysis was performed at the end of resuscitation.The rats were sacrificed 72 hours after resuscitation.Blood samples were taken to measure the plasma levels of blood urea nitrogen(BUN),creatinine,interleukin-1β(IL-1β),interleukin-6(IL-6)and tumor necrosis factorα(TNFα).Caspase-3 expression was detected by immunohistochemistry in kidney sections.The degree of renal injury was evaluated by regular HE staining and electron microscope.Compared with normal saline resuscitation,sodium potassium calcium magnesium glucose injection resuscitation could decrease the levels of BUN,serum creatinine,IL-1β,IL-6 and TNFα(P<0.05),reduce the expression of caspase-3(P<0.05),and improve the renal injury score(P<0.05).Sodium potassium calcium magnesium glucose injection resuscitation can significantly improve the renal function of sepsis rats with less pathological damage of the kidney.