尿KIM-1蛋白诊断早期造影剂肾病的实验研究

目的测定大鼠尿液肾损伤分子-1(KIM-1)蛋白含量以研究其在造影剂肾病(RCIN)早期诊断中的价值。方法成年雄性SD大鼠72只随机分为A、B、C组(n=8)和D组(D组又分为2,6,12,24,48 h和7 d小组,n=8),采用尾静脉注射方法,每组注射3种药物,均间隔15 min。A组注射磷酸盐缓冲液(PBS)、生理盐水(NS);B组注射PBS、NS和造影剂(CM);C组注射吲哚美辛(INDO)、一氧化氮合酶抑制剂(L-NAME)和NS;D组注射INDO、L-NAME和CM。结果 D组大鼠给药6 h后血清肌酐(Scr)和尿素氮(BUN)含量显著升高(P<0.001),在给药24 h达到高峰,并于48 h基本恢复正常。组织学可见D组用药后6 h出现显著的病理学变化,出现小管间质弥漫性充血、出血,明显的肾小管坏死和肾小管结构消失;给药后12 h仍然存在显著的小管坏死,以及肾小管结构消失,但是小管间质充血出血程度减轻;给药后24 h肾髓质外带小管已经再生;给药后7 d时肾小管结构仍未完全恢复。D组给药后尿液KIM-1值和NAG值在各时间点均有不同程度升高,尿液KIM-1值在给药后2 h开始升高,24 h达高峰,并持续到7 d(P<0.001);尿液NAG值在6 h开始升高,48 h基本恢复正常;尿液MMP-9值在D组给药后各组均未见升高。结论测定大鼠尿KIM-1含量可以作为早期诊断RCIN的指标之一。

Value of urinary kidney injury molecule-1 protein in early diagnosis of radiocontrast-induced nephropathy in rats

Objective To assess the value of determination of urine kidney injury molecule-1(KIM-1) protein content in the early diagnosis of radiocontrast-induced nephropathy(RCIN) in rats.Methods Seventy-two adult male SD rats were randomly divided into groups A,B,C(n=8) and D group(which was subdivided into 2,6,12,24,48 h and 7 days groups,n=8).Group A was subject to injections via the tail vein of PBS and normal saline(NS),group B received injections of PBS,NS,and contrast medium(CM),group C with indomethacin(INDO)...