促红细胞生成素对大鼠移植肾缺血-再灌注损伤的防护作用

目的探讨促红细胞生成素（erythropoietin，EPO）对大鼠移植肾缺血-再灌注损伤（ischemia—reperfusion injury，IRI）的保护作用。方法采用BN大鼠和Lewis大鼠，分别随机分为实验组和对照组，每组各15只。BN大鼠作为供体，Lewis大鼠为受体，建立单侧原位大鼠肾移植模型。实验组受体大鼠术后立即腹腔注射重组人促红细胞生成素（recombinant human erythropoietin，rhEPO）1000U／kg，对照组大鼠同样予腹腔注射等量生理盐水。两组受体大鼠在术后5d剪尾取血，检测血清肌酐（Scr）水平。同时将移植肾取出，肾组织行病理切片苏木素-伊红（HE）染色、过碘酸-雪夫（periodic acid Schiff，PAS）染色、马松（Masson）染色和过碘酸六胺银（periodic acid—silver methenamine，PASM）染色，观察肾组织病理学改变情况。结果实验组受体大鼠术后Scr水平为（102±3）μmol／L，对照组为（369±7）μmol／L，两者比较差异有统计学意义（P〈0．05）。两组受体大鼠移植肾均出现肾小管坏死改变。对照组移植肾组织病理切片主要表现为大片肾组织坏死，提示出现严重的急性排斥反应、肾小管坏死及动脉损伤；实验组肾组织病理切片主要表现为肾被膜下小灶性肾组织凝固性坏死；与对照组相比，实验组肾组织坏死面积较小，提示急性排斥反应程度较轻。结论肾移植术后早期使用EPO进行预处理可抑制肾脏IRI炎症反应，减少细胞凋亡，缓解移植后IRI。

Protective effect of erythropoietin on graft ischemia-reperfusion injury after renal transplantation in rats

Objective To investigate the protective effect of erythropoietin （EPO） on ischemia- reperfosion injury （IRI） of transplant kidney in rats. Methods BN rats and Lewis rats were divided into experimental group （ n = 15 ） and control group （ n = 15 ）. Unilateral orthotopic renal transplantation model was established with BN rats as donors and Lewis rats as recipients. The rats as recipients in experimental group received intraperitoneal injection of recombinant human erythropoietin （rbEPO, 1 000 U/kg ） after transplantation, while the rats in control group received intraperitoneal injection of the equal normal saline. The serum creatinine （Scr） level of rats＇ tail blood in two recipient groups was detected at 5 d after transplantation by cutting the tails. And the kidneys were harvested at the same time. The pathological section of renal tissue was dyed by hematoxylin-eosin （HE）, periodic acid Schiff （PAS）, Masson and periodic acid-silver methenamine （PASM）. The pathological change in renal tissue was observed. Results The Scr levels of rats as recipients were （ 102 ± 3 ） μmol/L in experimental group and （369 ± 7 ） μmol/L in control group. There was significant difference between two groups （ P 〈 0. 05 ）. Renal tubular necrosis was observed in transplant kidney of recipient rats in two groups. The pathological section of renal tissue in control group showed that large tissue necrosis, tubular necrosis and artery injury, which suggested severe acute rejection. The pathological section of renal tissue in experimental group showed that small coagulative necrosis of renal tissue under renal capsule. Compared with control group, the necrosis area of renal tissue was smaller in experimental group, which suggested acute rejection was milder in experimental group. Conclusions Early using of EPO after renal transplantation can inhibit inflammatory response of renal IRI, reduce cell apoptosis and ease IRI after transplantation.