中国急救医学
中國急救醫學
중국급구의학
CHINESE JOURNAL OF CRITICAL CARE MEDICINE
2015年
5期
394-397
,共4页
金魁%刘宝%邵敏%周树生%高晓兰
金魁%劉寶%邵敏%週樹生%高曉蘭
금괴%류보%소민%주수생%고효란
急性肾损伤(AKI)%盲肠结扎穿刺模型%脓毒症%生物学标志物%炎症因子
急性腎損傷(AKI)%盲腸結扎穿刺模型%膿毒癥%生物學標誌物%炎癥因子
급성신손상(AKI)%맹장결찰천자모형%농독증%생물학표지물%염증인자
Acute kidney injury( AKI)%Sepsis%Cecum ligation and puncture%Biomarkers%Cytokine
目的:研究使用小鼠盲肠结扎穿刺( CLP)模型,模拟脓毒症急性肾损伤( AKI)病理生理过程,研究不同结扎长度(比率)对死亡率的影响,选取最为适宜的结扎长度,并观察结扎后肾损伤标志物及肾脏病理变化。方法实验共纳入81只小鼠分别进行:①生存率研究分为CLP组(以25%、50%结扎比率)及假手术组,观察7 d记录生存时间。②选取生存率较为适合的结扎比率,再次行CLP术后,检测肾脏损伤标志物血清肌酐( Cr)、中性粒细胞酯酶( NGAL)、胱抑素C (Cystatin C)及白细胞介素-6(IL-6)。③AKI发生后进行肾脏病理检查。结果 CLP模型盲肠结扎50%与25%24 h死亡率100% vs 7%;结扎25%后,肾脏损伤标志物胱抑素C、中性粒细胞酯酶、血清肌酐于CLP术后2 h开始升高,胱抑素C于术后18 h达峰,中心粒细胞酯酶及肌酐于术后24 h达峰,IL-6于术后6 h达峰。病理检查提示,肾小管上皮细胞空泡形成明显增多,电镜检查提示空泡内含吞噬线粒体结构。结论 CLP模型可模拟脓毒症相关性肾损伤,其损伤达峰时间为造模后24 h。肾脏病理检查提示肾小管上皮空泡改变。
目的:研究使用小鼠盲腸結扎穿刺( CLP)模型,模擬膿毒癥急性腎損傷( AKI)病理生理過程,研究不同結扎長度(比率)對死亡率的影響,選取最為適宜的結扎長度,併觀察結扎後腎損傷標誌物及腎髒病理變化。方法實驗共納入81隻小鼠分彆進行:①生存率研究分為CLP組(以25%、50%結扎比率)及假手術組,觀察7 d記錄生存時間。②選取生存率較為適閤的結扎比率,再次行CLP術後,檢測腎髒損傷標誌物血清肌酐( Cr)、中性粒細胞酯酶( NGAL)、胱抑素C (Cystatin C)及白細胞介素-6(IL-6)。③AKI髮生後進行腎髒病理檢查。結果 CLP模型盲腸結扎50%與25%24 h死亡率100% vs 7%;結扎25%後,腎髒損傷標誌物胱抑素C、中性粒細胞酯酶、血清肌酐于CLP術後2 h開始升高,胱抑素C于術後18 h達峰,中心粒細胞酯酶及肌酐于術後24 h達峰,IL-6于術後6 h達峰。病理檢查提示,腎小管上皮細胞空泡形成明顯增多,電鏡檢查提示空泡內含吞噬線粒體結構。結論 CLP模型可模擬膿毒癥相關性腎損傷,其損傷達峰時間為造模後24 h。腎髒病理檢查提示腎小管上皮空泡改變。
목적:연구사용소서맹장결찰천자( CLP)모형,모의농독증급성신손상( AKI)병리생리과정,연구불동결찰장도(비솔)대사망솔적영향,선취최위괄의적결찰장도,병관찰결찰후신손상표지물급신장병리변화。방법실험공납입81지소서분별진행:①생존솔연구분위CLP조(이25%、50%결찰비솔)급가수술조,관찰7 d기록생존시간。②선취생존솔교위괄합적결찰비솔,재차행CLP술후,검측신장손상표지물혈청기항( Cr)、중성립세포지매( NGAL)、광억소C (Cystatin C)급백세포개소-6(IL-6)。③AKI발생후진행신장병리검사。결과 CLP모형맹장결찰50%여25%24 h사망솔100% vs 7%;결찰25%후,신장손상표지물광억소C、중성립세포지매、혈청기항우CLP술후2 h개시승고,광억소C우술후18 h체봉,중심립세포지매급기항우술후24 h체봉,IL-6우술후6 h체봉。병리검사제시,신소관상피세포공포형성명현증다,전경검사제시공포내함탄서선립체결구。결론 CLP모형가모의농독증상관성신손상,기손상체봉시간위조모후24 h。신장병리검사제시신소관상피공포개변。
Objective To examine the mortality and acute kidney injury in the cecum ligation and puncture ( CLP ) model with different ligation proportion.Methods Eighty -one mice were assigned to 3 different experiments.①Survival analysis between 25% vs 50% ligation of CLP model.②Analysis of 3 renal injury biomarkers (serum creatinine, NGAL, cystatin C) and cytokine of IL-6.③Renal histopathology at the most severely injured time point.Results The mortality rate of 50%ligation of CLP model at 48 hours was 100% whereas the 25% ligation mortality at 24 hours was 7%, and the 48 hours mortality was about 50%.Renal biomarkers of Creatinine, NGAL increased from 2 hours and reach their peak at 24 hours, by contrast, Cystatin C and IL-6 reach the highest level at 18 and 6 hours.Apical vacuolization can be found in the histopathology of kidneys at 24 hours after CLP but with absence of necrosis.Conclusion Cecum ligation ( 25%) and puncture through and through (2 holes) can mimic sepsis induced AKI, study of biomarkers of renal injury show kidney injury may most severely at 24 hours.