加味生脉散对脓毒症大鼠急性肾损伤的保护作用研究

Experimental study on protective effect of Jiawei Shengmai San on acute kidney injury in rats with septic

目的探讨加味生脉散对脓毒症大鼠急性肾损伤的影响。方法将60只SPF级健康成年雄性SD大鼠随机分为对照组、假手术组、模型组和加味生脉散低、中、高剂量(10、20、30 g/kg)组,每组10只。除对照组外,采用盲肠结扎穿孔术建立脓毒症大鼠模型,假手术组不进行盲肠结扎和穿孔,其余操作相同。术后ig给药1次,各组分别于术后0、3、6、12 h眼后静脉丛采血,试剂盒法检测血清大鼠胱抑素C(CysC)和肾损伤分子-1(KIM-1)、尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、全血乳酸、血清肌酐(Scr)水平;并于12 h处死每组大鼠各3只,HE染色后进行肾组织病理观察,免疫组化法检测肾组织缺氧诱导因子(HIF)-1α水平。结果术后3~12 h,加味生脉散低、中、高剂量组动物血清CysC、尿NGAL、Scr值显著低于模型组(P<0.05);术后6~12 h,高、中、低剂量组动物血清KIM值显著低于模型组(P<0.05);术后12 h,高、中、低剂量组全血乳酸值显著低于模型组(P<0.05)。与模型组比较,加味生脉散高、中、低剂量组动物病理变化程度轻微。模型组动物肾组织皮、髓质交界处弥漫性HIF-1α阳性表达,皮质阳性表达明显;加味生脉散高、中剂量组动物肾组织外髓质内带弱阳性表达HIF-1α,皮质无阳性表达;低剂量组动物肾组织外髓质内带阳性表达明显,皮质弱阳性表达。结论加味生脉散具有保护脓毒休克合并急性肾损伤大鼠肾功能的作用。

Objective To investigate the effect and mechanism of Jiawei Shengmai San powder on septic shock complicated with acute renal injury.Methods Totally 60 SPF healthy adult male SD rats were divided into three groups:control group,sham group,model group,Jiawei Shengmai San high,medium and low dose(10,20 and 30 g/kg)group.The models of Sepsis were established by CLP in all groups except the control group.The sham group only performed the same procedure without cecal ligation and perforation.Blood samples were taken from the retroorbital vein at the time points of 0,3,6 and 12 h in each group,and the indexes of CYSC,KIM-1,Ngal,lactic acid and Scr were measured at different time points in each group,and three rats in each group were killed at 12 h,pathological observation of Renal Tissue and detection of HIF-1 were performed.Results The values of serum CYSC,urine Ngal and Scr in the high,middle and low dose groups of 3 to 12 h were lower than those in the model group(P<0.05).The serum Kim values in the high,middle and low dose groups of 6 to 12 h were significantly lower than those in the model group(P<0.05).The values of whole blood lactic acid in the high,middle and low dose groups of 12 h were lower than those in the model group(P<0.05).Compared with model group,the pathological changes of Jiawei Shengmai San in high,middle and low dose groups were relatively slight.There was a weak positive expression in the outer medulla of the kidney tissue in the high and middle dosage groups,but not in the cortex of the kidney tissue in the low dosage groups.Conclusion Jiawei Shengmai San has protective effect on renal function in rats with septic shock and acute renal injury.