甘露醇对颅内高压兔肾功能影响的剂量效应实验研究

Experimental Study on Dose-effect of Mannitol's Impact on Renal Function of Rabbits With Intracranial Hypertension

目的 :研究不同剂量甘露醇治疗颅内高压后对实验动物肾功能的影响。方法 :将大白兔随机分为 4组 ,利用微量泵注射自体血法建立急性脑内血肿模型。对照组注射生理盐水 ,其他 3组给予不同剂量的甘露醇治疗 ,即小剂量组 0 .2 5g/kg ,中剂量组 1.0 g/kg ;大剂量组2 .0g/kg。测定给药前后血钠、血钾、尿素、肌酐。结果 :与给药前相比 ,用药 3h后各治疗组均引起血钠降低 ,小剂量组、中剂量组有统计学意义 (P <0 .0 5 ) ,大剂量组则降低更明显 (P <0 .0 1) ;而各治疗组均出现血钾、尿素升高趋势 ,但无统计学意义 (P >0 .0 5 ) ;小剂量组、中剂量组出现肌酐升高趋势 ,大剂量组则引起显著升高 (P <0 .0 1)。结论 :甘露醇对肾功能有不良影响 ,且随着剂量的增加 ,不良影响逐渐加重。护士可通过观察病人临床表现和分析实验室检查结果 。

Objective: to study the impacts on renal function of using mannitol in different dosages to treat experimental animals with intracranial hypertension. Methods: experimental animals were divided into 4 groups randomly, to establish an animal model with acute intracerebral hematoma, autoblood re-infusion via micro-pump were performed in all experimental animals. Animals in control group were injected with normal saline. Animals of other 3 groups were given mannitol in different dosages. That is, small dose group with mannitol 0.25 g/kg, medium dose group accepted mannitol 1.0 g/kg, and large dose group accepted mannitol 2.0 g/kg. Serum sodium, potassium, urea, and creatinine of animals in all groups were detected both before and after the treatment. Results: compared with before the mannitol infusion, all animals in treatment group developed hyponatremia 3 h after the treatment. There was statistical significance between the small dose and medium dose groups (P<0.05). Serum sodium was decreased more obviously in animals of large dose group (P<0.01). Animals in all treatment groups were with slight hyperkalemia and hyperuremia, but there was no statistical significance (P>0.05). Animals of both small dose and medium dose groups developed blood creatinine elevation, however, animals in large dose group developed blood creatinine serious elevation (P<0.01). Conclusion: mannitol infusion had negative impacts on renal function. Moreover, as the dose increased, negative impacts of it were even severe. For nurses, one could judge the possible poor consequences through observing the manifestation and analyzing the results of experimental examination, doing so, one could avoid the deterioration of illness of patients.