摘要
目的 评价连续性肾脏替代治疗（CRRT）对体外膜肺氧合（ECMO）诱导猪肾组织炎性因子表达的影响.方法 健康成年家猪24只,雌雄不限,体重25 ～ 32 kg,采用随机数字表法将其分为4组（n=6）：正常对照组（C组）、假手术组（S组）、ECMO组和CRRT组.S组给予麻醉、气管切开、机械通气、静脉置管和全身抗凝.ECMO组处理同S组,静脉置管后1h行ECMO.CRRT组静脉置管后1h同时进行ECMO和CRRT.ECMO和CRRT进行24h时,处死动物,取肾组织,采用EHSA法测定IL-1β、IL-6和TNF-α的含量.结果 C组与S组肾组织IL-1β、IL-6及TNF-α的含量比较差异无统计学意义（P＞0.05）.与C组和S组比较,ECMO组和CRRT组肾组织IL-1β、IL-6及TNF-α的含量升高（P＜0.01）；与ECMO组比较,CRRT组肾组织IL-1β、IL-6及TNF-α的含量降低（P＜0.01）.结论 CRRT可一定程度地降低ECMO诱导的猪肾组织炎性因子表达,提示其可减轻肾组织炎性反应.
Objective To evaluate the effect of continuous renal replacement therapy （CRRT） on extracorporeal membrane oxygenation （ECMO）-induced expression of inflammatory factors in pig kidney.Methods Twenty-four adult pigs of either sex,weighing 25-32 kg,were randomly divided into 4 groups （n =6 each） using a？ random number table：control group （group C）,sham operation group （group S）,ECMO group and CRRT group.Anesthesia was induced with ketamine,diazepam and atropine and maintained with ketamine and diazepam.The pigs were tracheotomized,intubated and mechanically ventilated.The left femoral arteries were cannulated for MAP monitoring.Heparin 150 U/kg was injected intravenously.Right femoral artery and left internal jugular vein were cannulated for blood-letting and fluid infusion.In ECMO and CRRT groups,ECMO was performed for 24 h starting from 1 h after cannulation,in addition CRRT was performed for 24 h simultaneously in ECMO group.The pigs were then sacrificed and kidney specimens were obtained for determination of the content of interleukin-1β （IL-1 β）,IL-6 and tumor necrosis factor-α （TNF-α） by ELISA.Results There was no significant differ-ence in the content of IL-1β,IL-6 and TNF-α between C and S groups （P 〉 0.05）.Compared with C and S groups,the content of IL-1β,IL-6 and TNF-α was significantly increased in E and CRRT groups （P 〈 0.01）.Compared with group E,the content of IL-1β,IL-6 and TNF-α was significantly decreased in group CRRT （P 〈0.01）.Conclusion CRRT can decrease ECMO-induced expression of inflammatory factors in pig kidney to some extent,indicating that it can alleviate the inflammatory responses in kidney.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2013年第9期1145-1147,共3页
Chinese Journal of Anesthesiology
关键词
肾替代疗法
体外膜氧合作用
肾
炎症
Renal replacement therapy
Extracorporeal membrane oxygenation
Kidney
Inflammation
