中国急救医学
中國急救醫學
중국급구의학
Chinese Journal of Critical Care Medicine
2015年
11期
969-972
,共4页
邓云汐%芮蕾%陈威丞%温汉春%朱继金
鄧雲汐%芮蕾%陳威丞%溫漢春%硃繼金
산운석%예뢰%진위승%온한춘%주계금
脓毒症%急性肾损伤(AKI)%血小板活化%氯吡格雷%阿司匹林
膿毒癥%急性腎損傷(AKI)%血小闆活化%氯吡格雷%阿司匹林
농독증%급성신손상(AKI)%혈소판활화%록필격뢰%아사필림
Sepsis%Acute kidney injury (AKI)%Platelet activation%Clopidogrel%Aspirin
目的 探讨脓毒症大鼠急性肾损伤(AKI)与血小板活化的关系及阿司匹林联合氯吡格雷双重抗血小板的效应. 方法 40 只雄性Wistar大鼠随机分为对照组( N组)、内毒素组(LPS组)、阿司匹林组(A组)、氯吡格雷组(C组)、阿司匹林+氯吡格雷组(A+C组),每组8只.N组、LPS组均给予生理盐水1 mL,A组、C组、A+C组则分别给予阿司匹林(100 mg/kg)、氯吡格雷(200 mg/kg)、阿司匹林(100 mg/kg)+氯吡格雷(200 mg/kg)灌胃3 d预处理后,N组腹腔注射生理盐水(10 mL/kg),余组腹腔注射LPS 10 mg/kg造模,造模6 h后采集标本进行分析,检测血清胱抑素C(Cys C)、血肌酐(SCr)及尿素氮(BUN);流式细胞仪测全血中血小板CD62p、TLR4表达水平、全血电阻法测血小板聚集率;ELISA法测血清TNF-α及IL-6水平;肾脏湿/干质量比( W/D)进行比较,取肾组织石蜡包埋切片,HE染色,光镜下观察大鼠肾脏组织结构改变. 结果 与LPS组比较,药物干预各组肾脏W/D、肾脏病理改变减轻;SCr、BUN、Cys C、血小板聚集率、CD62p、TLR4表达水平及血清TNF-α、IL-6均有所降低(P<0.05), 而A+C组下降最明显( P<00.1 ) ,差异均有统计学意义.结论 阿司匹林联合氯吡格雷对脓毒症大鼠AKI有协同保护作用,其机制可能为阻断血小板活化和聚集信号通路,降低血清TNF-α、IL-6水平,进而调节炎症反应.
目的 探討膿毒癥大鼠急性腎損傷(AKI)與血小闆活化的關繫及阿司匹林聯閤氯吡格雷雙重抗血小闆的效應. 方法 40 隻雄性Wistar大鼠隨機分為對照組( N組)、內毒素組(LPS組)、阿司匹林組(A組)、氯吡格雷組(C組)、阿司匹林+氯吡格雷組(A+C組),每組8隻.N組、LPS組均給予生理鹽水1 mL,A組、C組、A+C組則分彆給予阿司匹林(100 mg/kg)、氯吡格雷(200 mg/kg)、阿司匹林(100 mg/kg)+氯吡格雷(200 mg/kg)灌胃3 d預處理後,N組腹腔註射生理鹽水(10 mL/kg),餘組腹腔註射LPS 10 mg/kg造模,造模6 h後採集標本進行分析,檢測血清胱抑素C(Cys C)、血肌酐(SCr)及尿素氮(BUN);流式細胞儀測全血中血小闆CD62p、TLR4錶達水平、全血電阻法測血小闆聚集率;ELISA法測血清TNF-α及IL-6水平;腎髒濕/榦質量比( W/D)進行比較,取腎組織石蠟包埋切片,HE染色,光鏡下觀察大鼠腎髒組織結構改變. 結果 與LPS組比較,藥物榦預各組腎髒W/D、腎髒病理改變減輕;SCr、BUN、Cys C、血小闆聚集率、CD62p、TLR4錶達水平及血清TNF-α、IL-6均有所降低(P<0.05), 而A+C組下降最明顯( P<00.1 ) ,差異均有統計學意義.結論 阿司匹林聯閤氯吡格雷對膿毒癥大鼠AKI有協同保護作用,其機製可能為阻斷血小闆活化和聚集信號通路,降低血清TNF-α、IL-6水平,進而調節炎癥反應.
목적 탐토농독증대서급성신손상(AKI)여혈소판활화적관계급아사필림연합록필격뢰쌍중항혈소판적효응. 방법 40 지웅성Wistar대서수궤분위대조조( N조)、내독소조(LPS조)、아사필림조(A조)、록필격뢰조(C조)、아사필림+록필격뢰조(A+C조),매조8지.N조、LPS조균급여생리염수1 mL,A조、C조、A+C조칙분별급여아사필림(100 mg/kg)、록필격뢰(200 mg/kg)、아사필림(100 mg/kg)+록필격뢰(200 mg/kg)관위3 d예처리후,N조복강주사생리염수(10 mL/kg),여조복강주사LPS 10 mg/kg조모,조모6 h후채집표본진행분석,검측혈청광억소C(Cys C)、혈기항(SCr)급뇨소담(BUN);류식세포의측전혈중혈소판CD62p、TLR4표체수평、전혈전조법측혈소판취집솔;ELISA법측혈청TNF-α급IL-6수평;신장습/간질량비( W/D)진행비교,취신조직석사포매절편,HE염색,광경하관찰대서신장조직결구개변. 결과 여LPS조비교,약물간예각조신장W/D、신장병리개변감경;SCr、BUN、Cys C、혈소판취집솔、CD62p、TLR4표체수평급혈청TNF-α、IL-6균유소강저(P<0.05), 이A+C조하강최명현( P<00.1 ) ,차이균유통계학의의.결론 아사필림연합록필격뢰대농독증대서AKI유협동보호작용,기궤제가능위조단혈소판활화화취집신호통로,강저혈청TNF-α、IL-6수평,진이조절염증반응.
Objective To investigate the possible protective effects of aspirin combined clopidogrel on acute kidney injury in rats with sepsis , and its possible mechanism .Methods Forty male Wistar rats were randomly divided into five groups: control group ( group N) , endotoxin group ( group LPS ) , aspirin group ( group A ) , clopidogrel group ( group C ) , aspirin plus clopidogrel group ( group A+C) , with 8 rats in each group .The rats in group N and group LPS were respectively treated with 1 mL normal saline, while the rats in groups A, C and A+Cwere respectively given aspirin (100 mg/kg), clopiogrel (200 mg/kg), aspirin (100 mg/kg) +clopidogrel (200 mg/kg) pretreatment by gavage for three days.Then normal saline was injected in control group (10 mL/kg) by intrapertoneal, rats in all the tested groups were administered with LPS (10 mg/kg) by the same way.The blood Cr, BUN, Cys C, TNF -α, IL-6 and the expression level of platelet CD 62p, TLR4, rate of platelet aggregation 6 h after LPS or saline injection were determined .At last, kidney wet/dry weight ratio ( W/D), pathological changes in the kidney were observed by hematoxylin eosin (HE) staining.Results Compared with LPS model group , renal function , the level of Cys C , TNF-αand IL-6 in serum, the expression of platelet aggregation , platelet CD62p, TLR4 and kidney W/D ratio, significantly decreased in drug intervention groups .The histological changes also lessened , especially in drug combination group.Conclusion Aspirin and clopidogrel can block the platelet activation pathway and inhibit the levels of TNF-αand IL-6 in serum, thus modify the inflammatory response and provide synergetic effects against acute kidney injury induced by sepsis .
