CAJ | 학술논문

目的：碘克沙醇对于肾功能不全大鼠肾损伤分子-1(kidney injury molecule-l，KIM-1)及肾小管上皮细胞凋亡率的干预研究。方法将48只Wistar雄性大鼠随机分为正常对照组，模型组，碘克沙醇组1、碘克沙醇组2(n=12)。模型组与碘克沙醇组均采用右肾切除及左肾动脉缩窄法制作肾损伤模型。分别在术前、术后2周内隔日经内眦静脉取血测定BUN、SCr及取尿测KIM-1值。术后第3周对模型组静脉注射生理盐水，碘克沙醇组1注射碘克沙醇（5 mL/kg）碘克沙醇组2注射碘克沙醇（10 mL/kg），观察碘克沙醇组在应用对比剂前与应用对比剂后3 h、24 h、48 h、72 h、7 d血尿素氮、肌酐和尿KIM-1的变化；术后第24 h、72 h、第7天，每组随机选取3只大鼠处死。采取TUNEL法测定并比较这四组动物的肾小管上皮细胞凋亡率。结果（1）与对照组相比，模型组血清BUN、SCr水平于术后第2天急剧升高(P＜0.01)，达术前2倍左右。之后逐步下降，手术后2周时稳定于术前1.5~2.0倍水平，但尿KIM-1无显著变化(P＞0.05)。（2）与模型组相比，碘克沙醇组2在注射后24 h、72 h、第7天BUN、SCr、KIM-1、肾小管上皮细胞凋亡率明显升高（P＜0.01），碘克沙醇组2尿KIM-1水平在碘克沙醇注射后3 h即升高，明显早于碘克沙醇组1的升高，差异具有显著性（P＜0.01）。结论通过采用左肾动脉缩窄及右肾切除的方法能制备慢性轻中度肾衰竭动物模型；碘克沙醇可引起慢性肾衰竭动物的急性肾损伤，具体机制可能和该对比剂诱导肾小管上皮细胞凋亡有关。KIM-1能作为对比剂肾病的早期预测指标。不同浓度的对比剂对肾小管的损伤作用是不同的。
목적：전극사순대우신공능불전대서신손상분자-1(kidney injury molecule-l，KIM-1)급신소관상피세포조망솔적간예연구。방법장48지Wistar웅성대서수궤분위정상대조조，모형조，전극사순조1、전극사순조2(n=12)。모형조여전극사순조균채용우신절제급좌신동맥축착법제작신손상모형。분별재술전、술후2주내격일경내자정맥취혈측정BUN、SCr급취뇨측KIM-1치。술후제3주대모형조정맥주사생리염수，전극사순조1주사전극사순（5 mL/kg）전극사순조2주사전극사순（10 mL/kg），관찰전극사순조재응용대비제전여응용대비제후3 h、24 h、48 h、72 h、7 d혈뇨소담、기항화뇨KIM-1적변화；술후제24 h、72 h、제7천，매조수궤선취3지대서처사。채취TUNEL법측정병비교저사조동물적신소관상피세포조망솔。결과（1）여대조조상비，모형조혈청BUN、SCr수평우술후제2천급극승고(P＜0.01)，체술전2배좌우。지후축보하강，수술후2주시은정우술전1.5~2.0배수평，단뇨KIM-1무현저변화(P＞0.05)。（2）여모형조상비，전극사순조2재주사후24 h、72 h、제7천BUN、SCr、KIM-1、신소관상피세포조망솔명현승고（P＜0.01），전극사순조2뇨KIM-1수평재전극사순주사후3 h즉승고，명현조우전극사순조1적승고，차이구유현저성（P＜0.01）。결론통과채용좌신동맥축착급우신절제적방법능제비만성경중도신쇠갈동물모형；전극사순가인기만성신쇠갈동물적급성신손상，구체궤제가능화해대비제유도신소관상피세포조망유관。KIM-1능작위대비제신병적조기예측지표。불동농도적대비제대신소관적손상작용시불동적。
Objective To observe the impact of Iodixanol against kidney injury molecule-1 and the renal tubular cell apoptosis in rats with renal insufifciency. Methods 48 male wistar rats were randomly divided into four groups:normal control group, model group, Iodixanol group1, Iodixanol group2 (n=12). Iodixanol groups and model group were applied the methods of left renal artery narrowing (30%), right nephrectomy to produce renal insufifciency model in rats respectively, in the preoperative and postoperative 2 weeks every other day by measuring the angular vein blood BUN, SCr and taking urine test of urinary kidney injury molecule-1 (KIM-1) values. After the ifrst three weeks of intravenous saline model group, iodixanol (5 mL/kg)injection of iodixanol group 1, iodixanol (10 mL/kg)injection of iodixanol group 2, the changes of blood urea nitrogen, creatinine and urinary KIM-1 of the two iodixanol groups before applying the contrast agent, after 3 h, 24 h, 48 h, 72 h and 7 d were observed. Three rats of each group were sacriifed in 24 h, 72 h and 7th day after injection of contrast agent. The renal tubular cell apoptosis rates were measured by TUNEL and the differences of each group were compared. Results After in the ifrst two days of surgery, serum BUN, SCr levels in model group were signiifcantly higher than that of the normal group (P<0. 0 1 ) and rised sharply up to about 2 times before surgery, Then gradually decreased after surgery stable at 1.5-2.0 times the preoperative levels two weeks. But the values of KIM-1 were no signiifcant difference (P>0.05). Compared with the model group, in 24 h, 72 h and 7th day after the injection of contrast agents, the values of BUN and SCr, the value of KIM-1 in urine and the rates of apoptosis of renal tubular cells in iodixanol group 2 were signiifcantly increased higher than that of the model group (P<0.01). After three hours iodixanol injection of iodixanol group 2, urinary KIM-1 levels that increased signiifcantly earlier than the rise in the iodixanol group1, the difference was signiifcant (P<0.01). Conclusion By using the left renal artery narrowing and right nephrectomy method can be prepared with mild to moderate chronic renal failure in animal models;iodixanol can cause acute kidney injury of chronic renal failure animals and the speciifc mechanisms may induce renal contrast agent tubule epithelial cell apoptosis. KIM-1 can be used as a contrast agent nephropathy early predictors. Different concentrations of contrast agents for renal tubular injury are different.