CAJ | 학술논문

目的：探讨重组人促红细胞生成素(rHuEPO)对盲肠结扎穿孔术(CLP)+检验性失血大鼠急性肾损伤的保护作用。方法160只SD大鼠CLP术后按照随机数表法取均分为四组(对照组、小剂量组、中剂量组和大剂量组)，每组各40只，四组均关腹后0 h、24 h、48 h尾静脉放血1 ml，小剂量组0 h皮下注射3000 U/kg+生理盐水1 ml (24 h、48 h皮下注射生理盐水1 ml)，中剂量组0 h、24 h皮下注射rHuEPO 3000 U/kg+生理盐水1 ml (48 h皮下注射生理盐水1 ml)，大剂量组0 h、24 h、48 h皮下注射3000 U/kg+生理盐水1 ml，对照组0 h、24 h、48 h皮下注射生理盐水1 ml，分笼饲养，72 h每组各取5只经心脏取血2 ml，检测血红蛋白(Hb)、尿素氮(BUN)、肌酐(Cr)、肿瘤坏死因子(TNF-α)，检测肾脏丙二醛(MDA)、髓过氧化物酶活性(MPO)、核转录因子(NF-κB)表达和末端脱氧核苷酸转移酶介导的脱氧尿苷三磷酸缺口标记(TUNEL)阳性细胞数。结果大中剂量组BUN、Cr、TNF-α、MDA、MPO、NF-κB、TUNEL阳性细胞数分别与对照组比较差异均有统计学意义(P<0.05)，大剂量组较中剂量组差异有统计学意义(P<0.05)，而小剂量组上述指标分别与对照组比较差异则均无统计学意义(P>0.05)，四组的Hb比较差异无统计学意义(P>0.05)。结论 rHuEPO能够降低盲肠结扎穿孔术+检验性失血所致急性肾损伤大鼠TNF-α、MDA、MPO、NF-κB表达和TUNEL阳性细胞数，对脓毒症和检验性失血双重打击急性肾功能损伤具有一定的保护作用，且呈剂量依赖性。
목적：탐토중조인촉홍세포생성소(rHuEPO)대맹장결찰천공술(CLP)+검험성실혈대서급성신손상적보호작용。방법160지SD대서CLP술후안조수궤수표법취균분위사조(대조조、소제량조、중제량조화대제량조)，매조각40지，사조균관복후0 h、24 h、48 h미정맥방혈1 ml，소제량조0 h피하주사3000 U/kg+생리염수1 ml (24 h、48 h피하주사생리염수1 ml)，중제량조0 h、24 h피하주사rHuEPO 3000 U/kg+생리염수1 ml (48 h피하주사생리염수1 ml)，대제량조0 h、24 h、48 h피하주사3000 U/kg+생리염수1 ml，대조조0 h、24 h、48 h피하주사생리염수1 ml，분롱사양，72 h매조각취5지경심장취혈2 ml，검측혈홍단백(Hb)、뇨소담(BUN)、기항(Cr)、종류배사인자(TNF-α)，검측신장병이철(MDA)、수과양화물매활성(MPO)、핵전록인자(NF-κB)표체화말단탈양핵감산전이매개도적탈양뇨감삼린산결구표기(TUNEL)양성세포수。결과대중제량조BUN、Cr、TNF-α、MDA、MPO、NF-κB、TUNEL양성세포수분별여대조조비교차이균유통계학의의(P<0.05)，대제량조교중제량조차이유통계학의의(P<0.05)，이소제량조상술지표분별여대조조비교차이칙균무통계학의의(P>0.05)，사조적Hb비교차이무통계학의의(P>0.05)。결론 rHuEPO능구강저맹장결찰천공술+검험성실혈소치급성신손상대서TNF-α、MDA、MPO、NF-κB표체화TUNEL양성세포수，대농독증화검험성실혈쌍중타격급성신공능손상구유일정적보호작용，차정제량의뢰성。
Objective To discuss the protective effects of recombinant human erythropoietin (rHuEPO) in rats with acute kidney injury under cecal ligation and puncture (CLP) and blood loss during laboratory test. Methods One hundred and sixty SD rats were averaged into four groups (control group, low-dose rHuEPO group, me-dian-dose rHuEPO group and high-dose rHuEPO group) through the random number table after CLP. 1 ml of tail vein blood each was taken 0 h, 24 h, 48 h after the abdomen closure. rHuEPO 3 000 U/kg+saline 1 ml was injected subcuta-neously in low-dose rHuEPO group at the time of 0 h , and 1 ml of saline was injected respectively at 24 h and 48 h. rHuEPO 3 000 U/kg+saline 1 ml was injected subcutaneously in median-dose rHuEPO group at the time of 0 h and 24 h, and 1 ml of saline was injected at 48 h. rHuEPO 3 000 U/kg+saline 1 ml was injected subcutaneously in high-dose rHuEPO group at the time of 0 h, 24 h and 48 h. The control group was injected with normal saline 1 ml each at the time of 0 h, 24 h and 48 h. Rats were separated in different cages for 72 h, then 5 out of each group were selected and drew 2 ml of blood each from the hearts to test hemoglobin hemoglobin (Hb), urea nitrogen (BUN), creatinine (Cr), tu-mor necrosis factorα(TNF-α), as well as the expression of malonaldehyde (MDA), myeloperoxidase (MPO) and nu-clear factor-κB (NF-κB) in their kidneys, and also, the amount of terminal dexynucleotidyl transferase (TdT)-mediat-ed dUTP nick end labeling (TUNEL) positive cells. Results The median-dose rHuEPO and high-dose rHuEPO group showed statistically significant differences respectively with the control group in the test results of BUN, Cr, TNF-α, MDA, MPO, NF-κB and TUNEL positive cells (P<0.05). The differences in the above indexes between the high-dose rHuEPO group and the median-dose rHuEPO group were statistically significant (P<0.05), while the differ-ences between the low-dose rHuEPO group and the control group was not different (P>0.05). The four groups showed no statistically significant difference from each other inHb (P>0.05). Conclusion rHuEPO could decrease the expres-sion of MDA, MPO, NF-κB and the TUNEL positive cells in the rats with acute kidney injury under the circumstanc-es of CLP and blood loss during laboratory test. It has a certain extent of protective effects for the acute kidney injury caused by sepsis and blood loss during laboratory test, which also demonstrates a feature of dose-dependence.