乌司他丁对心肺复苏后兔肾损伤的影响

目的: 通过观察乌司他丁(UTI)对心肺复苏(CPR)后兔肾髓质内炎症细胞浸润程度、TNF-α表达和氧化应激产物丙二醛(MDA)含量的影响,探讨UTI对CPR后肾功能损伤的机制。方法: 24只雄性新西兰成年大白兔,采用交流电诱发室颤的方式建立CPR模型,自主循环恢复(ROSC)后动物随机分为对照(control)组和UTI治疗组,每4 h记录尿量、采血,检测尿素氮(BUN)、肌酐(Cr)水平,ROSC 24 h后取肾髓质,观察炎症细胞浸润程度、TNF-α表达及MDA的含量。结果: Control组和UTI治疗组均有6只动物存活至实验结束。ROSC后2组动物的尿量均逐渐下降,8 h-16 h降至最低,随后逐渐增加,UTI组动物尿量明显多于control组(P＜0.05)。ROSC后12h-20h血清BUN和Cr达最高水平,其中ROSC后4 h UTI组明显低于control组(P＜0.05)。ROSC后24 h control组髓过氧化物酶阳性细胞数、TNF-α表达及MDA含量均高于UTI组(P＜0.05)。结论: 兔室颤5 min进行CPR,ROSC后给予UTI可减轻ROSC后24 h肾髓质内炎症细胞的浸润程度、减少TNF-α的表达和降低MDA含量,从而减轻肾功能损伤。

Protective effects of ulinastatin on kidney injury in rabbits after cardiopulmonary resuscitation

AIM: To investigate the effect of ulinastatin (UTI) on inflammatory cell infiltration, expression of tumor necrosis factor-α (TNF-α) and concentration of oxidative stress product malondialdehyde (MDA) in the kidney medulla after cardiopulmonary resuscitation (CPR) in rabbits and to access its potential mechanisms in kidney injury after CPR.METHODS: Twenty-four male New Zealand adult rabbits were randomly divided into control group and UTI group after return of spontaneous circulation (ROSC) from 5 min ventricular fibrillation induced by alternating current. The UTI at the dose of 2.5×10⁴ U/kg was administered immediately after ROSC to the animals in UTI group, the same volume of saline were injected in control group. The urinary output was recorded and the serum concentration of BUN and creatinine were detected every 4 h after ROSC. The animals were sacrificed 24 h after ROSC and the kidney medullas were obtained to observe the degree of inflammatory cell infiltration, the expression of TNF-α and the concentration of MDA.RESULTS: Six rabbits in control group and 6 animals in UTI group survived to the end point of experiment. The urinary output was decreased gradually to the lowest 8 h-12 h after ROSC and then increased in both groups. The urinary output in UTI group was more than that in control group 8 h after ROSC (P<0.05). The serum concentrations of BUN and creatinine were significantly lower in UTI group than those in control group 4 h after ROSC (P<0.05). The myeloperoxidase-positive cells in control group were much higher than that in UTI group (P<0.05). The expression of TNF-α and concentration of MDA in the kidney medullas in UTI group were lower than those in control group (P<0.05, P<0.01).CONCLUSION: The standard dose of UTI (2.5×10⁴ U/kg) administered in rabbits suffered from ventricular fibrillation for 5 min may alleviate the degree of inflammatory cell infiltration, decrease the expression of TNF-α and reduce the concentration of MDA in kidney medulla. UTI has protective effects on the renal function after CPR.