KIM-1及NGAL在苯酚烧伤致大鼠早期肾损伤中的表达水平及意义

Expression Levels and Significance of KIM-1 and NGAL in Early Renal Injury of Rats Caused by Phenol Burns

目的观察肾损伤分子-1(KIM-1)及中性粒细胞明胶酶相关载脂蛋白(NGAL)在苯酚烧伤致大鼠早期肾损伤中的表达水平,并分析其临床意义。方法将48只SD大鼠随机分为对照组6只、实验组42只,对照组大鼠仅做背部脱毛处理,实验组大鼠建立苯酚烧伤模型,分别于烧伤后15、45 min以及2、4、8、16、32 h观察肾脏组织病理变化,并采用酶联免疫吸附试验(EISA)检测KIM-1、NGAL水平,肌氨酸氧化酶法检测血肌酐(Scr)水平,分析KIM-1、NGAL与肾损伤的相关性及其对肾损伤的诊断价值。结果苯酚烧伤大鼠创面呈浅红色至棕红色、质地稍韧,且伴有全身抽搐及肉眼血尿等表现;苏木精-伊红(HE)染色结果显示,烧伤32 h内大鼠肾脏组织逐渐出现肾小管空泡样变性、蛋白质管型、肾小管扩张、肾小管坏死等病理改变;烧伤后32 h内大鼠血清KIM-1、NGAL水平均呈先升高后降低的趋势,其中KIM-1水平于烧伤后15 min开始升高,8 h到达高峰;NGAL水平于烧伤后2 h开始升高,16 h到达高峰;而Scr水平升高不明显;血清KIM-1、NGAL水平与早期肾损伤具有显著相关性(r=0.664、0.730,P均<0.001),两者联合检测对诊断早期肾损伤具有显著优势。结论血清KIM-1及NGAL水平与苯酚烧伤所致的早期肾损伤程度密切相关,对诊断苯酚烧伤所致的早期肾损伤具有较高的临床应用价值。

Objective To observe the expression levels of kidney injury molecule-1(KIM-1)and neutrophil gelatinase-associated lipocalin(NGAL)in early renal injury of rats caused by phenol burns,and analyze their clinical significances.Methods Forty-eight SD rats were randomly divided into a control group(6 rats)and an experiment group(42 rats).The back hair removal was performed on rats in the control group,while phenol burn model was established on rats in the experiment group to observe the pathological changes of renal tissues at the time points of 15 min,45 min,2 h,4 h,8 h,16 h and 32 h postburn.The levels of KIM-1 and NGAL were measured with the enzyme-linked immunosorbent assay(ELISA),the level of serum creatinine(Scr)was tested with the sarcosine oxidase method,and their correlations with renal injury,as well as their diagnostic value for renal injury were analyzed.Results The wounds of rats with phenol burns were light red to brown red in color and slightly tough in texture,and the rats had the symptoms of generalized convulsion and visible hematuria.HE staining showed that the renal tissues of rats within 32 h postburn gradually developed vacuolar degeneration and protein cast of renal tubules,tubular dilation,and tubular necrosis and other pathological changes.Within 32 h postburn,the levels of serum KIM-1 and NGAL in rats presented a trend of decrease following increase,of which the level of KIM-1 started to rise at 15 min postburn,and reached the peak at 8 h postburn,While the levels of NGAL began to increase at 2 h postburn and peaked at 16 h postburn.In contrast,the increase of Scr was not significant.The levels of KIM-1 and NGAL showed significant correlations with the early renal injury(r=0.664 and 0.730,both P<0.001),and the combined detection of the two factors had a significant advantage in the diagnosis of early renal injury.Conclusion The levels of serum KIM-1 and NGAL are closely related to the severity of early renal injury of rats caused by phenol burns,and have a much high value of clinical application in diagnosing early renal injury in rats caused by phenol burns.