CAJ | 학술논문

目的：探寻肢体在被挤压时间的长短与发生急性肾损伤（AKI）严重程度的关系，为震后挤压伤的科学评估提供实验依据。方法24只大鼠随机均分为4组，双下肢被3 kg压力分别挤压8 h、16 h、24 h、48 h，在挤压前，和解压后2 h、6 h、12 h、24 h五个时间点采血，检测血清中肌红蛋白（Mb）和肌酐（Cr），最后将大鼠处死取肾脏做病理切片并镜下观察，对各组肾脏病理损伤进行评分。用重复测量资料方差分析比较各组Mb及Cr总体水平的差异，用单因素方差分析比较各组病理损伤评分的差异。结果挤压16 h组中的2只大鼠和挤压24 h组的1只大鼠在解除压迫后24 h内死亡；挤压16 h组大鼠的Mb和Cr总体水平均显著高于其他三组（均P＜0.05）；挤压8 h、24 h两组的Mb和Cr总体水平均显著高于挤压48 h组（均P＜0.05）。各组肾脏病理损伤评分两两比较的统计结果显示，挤压16h、24h两组病理损伤评分均显著高于其他两组（均P＜0.05），挤压16h组肾损伤评分显著高于挤压24h组（P＜0.05）。结论在相同的挤压部位及挤压重量下，肢体被挤压时间越长并不代表急性肾损伤程度越重。
목적：탐심지체재피제압시간적장단여발생급성신손상（AKI）엄중정도적관계，위진후제압상적과학평고제공실험의거。방법24지대서수궤균분위4조，쌍하지피3 kg압력분별제압8 h、16 h、24 h、48 h，재제압전，화해압후2 h、6 h、12 h、24 h오개시간점채혈，검측혈청중기홍단백（Mb）화기항（Cr），최후장대서처사취신장주병리절편병경하관찰，대각조신장병리손상진행평분。용중복측량자료방차분석비교각조Mb급Cr총체수평적차이，용단인소방차분석비교각조병리손상평분적차이。결과제압16 h조중적2지대서화제압24 h조적1지대서재해제압박후24 h내사망；제압16 h조대서적Mb화Cr총체수평균현저고우기타삼조（균P＜0.05）；제압8 h、24 h량조적Mb화Cr총체수평균현저고우제압48 h조（균P＜0.05）。각조신장병리손상평분량량비교적통계결과현시，제압16h、24h량조병리손상평분균현저고우기타량조（균P＜0.05），제압16h조신손상평분현저고우제압24h조（P＜0.05）。결론재상동적제압부위급제압중량하，지체피제압시간월장병불대표급성신손상정도월중。
Objective To explore the relationship between the severity of acute kidney injury (AKI) caused by crush injury and the time of compression upon limbs. Methods Twenty-four SD rats were randomly divided into 4 equal groups to undergo compression of 3 kg upon their both lower extremities for 8, 16, 24 and 48 hours respectively. Samples of heart blood were collected before compression and 2,6,12, and 24 hours after decompression respectively to examine the serum myoglobin (Mb) and creatinine (Cr). At last all the rats were killed with their kidneys taken out to undergo pathological examination so as to record the pathological scoring. One-way ANOVA was used to analyze the relationship between the severity of AKI caused by crush injury and the time of limbs undergoing compression. Results Two rats of the crushing 16 h group and one rat of the crushing 24 h group died within 24 hours after decompression. The overall levels of Mb and Cr of the crushing 16 h group were both significantly higher than those of the other 3 groups (all P<0.05). The overall levels of Mb and Cr of the crushing 8 h and 24 h groups were both significantly higher than that of the crushing 48 h group (all P<0.05). The pathological scores of the crushing 16 h and 24 h groups were both significantly higher than those of the other 2 groups (all P<0.05), and the pathological score of the crushing 16 h group was significantly higher than that of the drushing 24 h group (P<0.05). Conclusion Under the same conditions of crushing weight and site being crushed, longer crushing time does not mean more severe AKI.