脓毒症急性肾损伤的早期诊断及生大黄的疗效研究(1)
[摘要] 目的 探讨脓毒症急性肾损伤的早期诊断指标及生大黄对其的保护作用。 方法 将60只大鼠按随机数字表法分为模型组(A)、治疗组(B)和对照组(C)三组，每组20只。模型组腹膜内注射脂多糖5 mg/kg诱导建立AKI模型，治疗组在腹膜内注射脂多糖即刻胃管内注入生大黄粉溶液，对照组腹膜内注射等量生理盐水。三组大鼠分别在处理前即刻(基础值，0 h)，处理后1、6、24 h测定尿Netrin-1及尿KIM-1含量，同时采集血样测定肌酐含量。 结果 大鼠注射脂多糖6 h后，血清肌酐及尿KIM-1水平开始明显上升，注射后1 h尿Netrin-1即有明显上升，6 h达到峰值，24 h左右逐渐下降；生大黄治疗组大鼠各时间点血清肌酐、尿Netrin-1及尿KIM-1上升程度均较模型组明显降低(P<0.05)。 结论 尿Netrin-1对脓毒症急性肾损伤有早期诊断作用，生大黄可降低脓毒症急性肾损伤大鼠Scr、尿Netrin-1及尿KIM-1水平，对肾脏有保护作用。
[关键词] 急性肾损伤；脓毒症；生大黄；Netrin-1
, 百拇医药
[中图分类号] R692 [文献标识码] A [文章编号] 1673-9701(2015)16-0004-04
[Abstract] Objective To study early diagnostic index of septic acute kidney injury(AKI) and protective effect of rhubarb on septic AKI. Methods Sixty rats were randomly divided into the following 3 groups： model group (A)， treatment group (B) and control group (C). Each group contains 20 rats. Rats from group A were received a intraperitoneal injection of lipopolysaccharide (LPS) at a dose of 5 mg/kg to induce AKI. Rats from group B were given rhubarb powder solution by oral administration immediately after LPS injection. Rats from group C were treated with the same volume of normal saline (NS) by intraperitoneal injection. Both serum level of creatinine (Scr) and urinary levels of Netrin-1 and KIM-1 of rats in 3 groups were detected in the different time points of treatment (0 h， 1 h， 6 h and 24 h). Results The levels of KIM-1 and CR in rats treated with LPS were obviously increased at the time point of 6 h (P<0.05). The urinary level of Netrin-1 began to increase at the time point of 1 h and reached the highest level at the time point of 6 h， then gradually decreased at the time point of 24 h after the injection of LPS. In group B， the levels of Scr， Netrin-1 and KIM-1 were significantly lower as compared with group A (P<0.05). Conclusion The urinary level of Netrin-1 might has early diagnostic value in septic acute kidney injury. Rhubarb could protect the kidney of AKI model rats by decreasing the serum level of Scr， urinary levels of Netrin-1 and KIM-1.
, 百拇医药
[Key words] Acute kidney injury； Sepsis； Rhubarb； Netrin-1
脓毒症(sepsis)是一种由感染诱发的全身炎症反应综合征，可引起多器官损伤。在脓毒症人群中急性肾损伤(acute kidney injury，AKI)发生并不少见，发生率随着脓毒症的严重度上升而增加，在中等程度、重症脓毒症和脓毒症休克患者中，AKI的发生率分别是19%、23%和51%，和其他原因相比，脓毒症所致的AKI血流动力学更不稳定，需要升压药与机械通气的患者比例较高，疾病严重度评分更高，最终导致死亡率也明显升高[1]。脓毒症AKI已成为医务工作者面临的重大医疗问题。近年来，随着对脓毒症和AKI的发病机制认识的深入，容量管理、内环境监控、器官支持的水平不断提高，虽然在脓毒症合并AKI治疗方面有所进展，但脓毒症AKI的病死率仍然居高不下，因此早期诊断及早期治疗是防治脓毒症AKI的最佳策略。本文从动物实验来探讨生大黄对脓毒症急性肾损伤的保护作用以探寻早期诊断急性肾损伤的可靠指标。, 百拇医药(韩芳 吴爱萍 孙仁华)
[关键词] 急性肾损伤；脓毒症；生大黄；Netrin-1
, 百拇医药
[中图分类号] R692 [文献标识码] A [文章编号] 1673-9701(2015)16-0004-04
[Abstract] Objective To study early diagnostic index of septic acute kidney injury(AKI) and protective effect of rhubarb on septic AKI. Methods Sixty rats were randomly divided into the following 3 groups： model group (A)， treatment group (B) and control group (C). Each group contains 20 rats. Rats from group A were received a intraperitoneal injection of lipopolysaccharide (LPS) at a dose of 5 mg/kg to induce AKI. Rats from group B were given rhubarb powder solution by oral administration immediately after LPS injection. Rats from group C were treated with the same volume of normal saline (NS) by intraperitoneal injection. Both serum level of creatinine (Scr) and urinary levels of Netrin-1 and KIM-1 of rats in 3 groups were detected in the different time points of treatment (0 h， 1 h， 6 h and 24 h). Results The levels of KIM-1 and CR in rats treated with LPS were obviously increased at the time point of 6 h (P<0.05). The urinary level of Netrin-1 began to increase at the time point of 1 h and reached the highest level at the time point of 6 h， then gradually decreased at the time point of 24 h after the injection of LPS. In group B， the levels of Scr， Netrin-1 and KIM-1 were significantly lower as compared with group A (P<0.05). Conclusion The urinary level of Netrin-1 might has early diagnostic value in septic acute kidney injury. Rhubarb could protect the kidney of AKI model rats by decreasing the serum level of Scr， urinary levels of Netrin-1 and KIM-1.
, 百拇医药
[Key words] Acute kidney injury； Sepsis； Rhubarb； Netrin-1
脓毒症(sepsis)是一种由感染诱发的全身炎症反应综合征，可引起多器官损伤。在脓毒症人群中急性肾损伤(acute kidney injury，AKI)发生并不少见，发生率随着脓毒症的严重度上升而增加，在中等程度、重症脓毒症和脓毒症休克患者中，AKI的发生率分别是19%、23%和51%，和其他原因相比，脓毒症所致的AKI血流动力学更不稳定，需要升压药与机械通气的患者比例较高，疾病严重度评分更高，最终导致死亡率也明显升高[1]。脓毒症AKI已成为医务工作者面临的重大医疗问题。近年来，随着对脓毒症和AKI的发病机制认识的深入，容量管理、内环境监控、器官支持的水平不断提高，虽然在脓毒症合并AKI治疗方面有所进展，但脓毒症AKI的病死率仍然居高不下，因此早期诊断及早期治疗是防治脓毒症AKI的最佳策略。本文从动物实验来探讨生大黄对脓毒症急性肾损伤的保护作用以探寻早期诊断急性肾损伤的可靠指标。, 百拇医药(韩芳 吴爱萍 孙仁华)