摘要
目的建立内毒素休克诱导急性肾损伤家兔的模型。方法将12只健康新西兰雄性家兔按随机数字法分为对照组(C组)和模型组(S组),每组6只。S组经耳缘静脉持续缓慢匀速泵入内毒素,平均动脉压(MAP)下降至基础的40%以下即认为脓毒性休克造模成功。C组经耳缘静脉匀速泵入等量生理盐水。经右颈外静脉置入中心静脉导管监测中心静脉压,采用脉搏指示连续心排血量(Pi CCO)监测仪动态监测家兔心率(HR)、每搏输出量变异率(SVV)、心室收缩力指数(dpmax)、全身血管阻力指数(SVRI),记录每小时尿量、血肌酐、动脉血乳酸。选择感染性休克成模时(T0)、成模后3 h(T3)、成模后6 h(T6)为观察时间点。观察6 h后处死动物,留取肾脏组织标本行HE染色和透射电镜显微镜观察肾组织结构改变。结果2组基础血流动力学指标无显著差异。S组内毒素注射60 min后MAP显著下降超过基础值的40%(P<0.01)且持续至观察终点。与基础值相比,S组造模成功后及各观察时间点的HR、SVV、动脉血乳酸均显著增高(P<0.01),dpmax、SVRI均显著降低(P<0.01)。与C组相比,S组各时间点HR、SVV、动脉血乳酸均显著较高(P<0.01),dpmax显著较低(P<0.05)。S组自成模开始至观察结束尿量显著少于C组(P<0.05),S组成模后尿肌酐显著升高(P<0.05),且显著高于C组(P<0.05)。病理显示S组6只家兔肾小管均出现水肿、管腔变小,上皮细胞空泡样改变,细胞界限不清,但未见有明显坏死表现,6只家兔均造模成功。结论静脉注射内毒素可以制备稳定的内毒素休克诱导急性肾损伤的家兔模型。
Objective To establish rabbit model with acute renal injury following endotoxic shock. Methods Twelve health male New Zealand rabbits were randomly divided into model group（group S） and control group（group C） according to random number table method, with 6 rabbits per group. The endotoxin was pumped continuously and slowly by ear marginal vein in group S, an successful endotoxic shock model was confirmed by mean arterial pressure（MAP）〈40% of the baseline. The equivalent normal saline was pumped in the same way in group C. A central venous catheter was intubated in the right external carotid vein to monitor central venous pressure. The pulse-indicated continuous cardiac output（PiCCO） was used to monitor dynamic rabbit heart rate （HR）, stroke volume variation （SVV）, ventricular contraction index （dp max ） and systemic vascular resistance index （SVRI）. Besides, the urine amount, serum creatinine and blood lactic acid were recorded hourly. The observation time points included model time（T 0）, three hours after modeling（T 3） and six hours after modeling（T 6）. After six hours, the rabbits were sacrificed, and the kidney tissue samples were removed for HE staining and transmission electron microscopy to observe structure changes. Results There was no significant difference in hemodynamic parameters between two groups. The group S had obviously decreased MAP for 40% of the basic value at 60 min after endotoxin injection （ P 〈0.01）, and its value maintained to the end of observation time. The HR, SVV and arterial blood lactic acid significantly increased in group S compared to the basic value in each time points （ P 〈 0.01）, while dp max and SVRI significantly decreased （ P 〈0.01）. The values of HR, SVV and arterial blood lactic acid in group C were significantly higher than that in control group in each time points （ P 〈0.01）, while the value of dp max was significantly lower （ P 〈0.05）. The urine volume in group S was significantly lower comp
作者
邵俊
方时书
郑瑞强
陈齐红
林华
於江泉
薛露
SHAO Jun;FANG Shishu;ZHENG Ruiqiang;CHEN Qihong;LIN Hua;YU Jiangquan;XUE Lu(ICU,Subei People′s Hospital of Jiangsu Province ＆ Clinical Medical School of Yangzhou University,Yangzhou,Jiangsu,225001;ICU,Taizhou People′s Hospital of Jiangsu Province,Taizhou,Jiangsu,225300)
出处
《实用临床医药杂志》
CAS
2018年第15期18-22,共5页
Journal of Clinical Medicine in Practice
基金
江苏省扬州市2017年度科学计划社会发展面上项目(YZ2017086)
关键词
内毒素
休克
急性肾损伤
家兔模型
电镜
endotoxin
shock
acute renal injury
rabbit model
electronic microscopy
