乌司他丁对失血性休克大鼠肾脏细胞凋亡的影响

目的观察乌司他丁（UTI）对失血性休克大鼠肾脏细胞凋亡的影响。方法将30只成年雄性SD大鼠采用随机数字表法分为对照组、休克组和UTI组，每组10只。建立失血性休克大鼠模型，于再灌注后6h取血，测定血清尿素氮（BUN）、肌酐（Cr）的含量。采用末端脱氧核苷酸转移酶介导dUTP缺口端标记法检测细胞凋亡指数（AI），免疫组化法测定肾小管上皮细胞Bcl-2、Bax蛋白的表达。结果与对照组比较，大鼠失血性休克再灌注6h后，休克组和UTI组血清BUN、Cr含量显著升高（均P〈0．01）。与休克组比较，UTI组的血清BUN、Cr含量显著降低（均P〈0．05）。与对照组比较，休克组和UTI组AI值、Bax、Bcl-2蛋白表达均显著升高（均P〈0．01），休克组Bcl-2／Bax显著降低（P〈0．01），UTI组Bcl-2／Bax显著升高（P〈0.01）。与休克组比较，UTI组AI显著降低（P〈0．05），Bax蛋白表达显著减弱（P〈0．05），Bcl-2蛋白表达显著增强（P〈005），Bcl-2／Bax比值显著升高（P〈0．01）。结论大鼠失血性休克再灌注后，肾功能下降，肾脏细胞凋亡增加。UTI对失血性休克大鼠肾脏有一定的保护作用。通过调节Bcl-2和Bax蛋白表达抑制。肾脏细胞凋亡是其可能的机制之一。

Effects of ulinastatin on cell apoptosis in rat kidneys after hemorrhagic shock

Objective To investigate the effects of ulinastatin on cell apoptosis and expressions of Bcl-2 and Bax in rat kidneys with reperfusion injury after hemorrhagic shock. Methods Thirty male adult SD rats were randomly divided into 3 groups： UTI group （A,n=10）,shock group （B,n=10） and control group （C,n=10）. The hemorrhagic shock was induced in group A and B. Blood samples were taken at 6h after reperfusion and the serum levels of BUN and Cr were measured. Cell apoptotic index（AI ） was examined by means of terminal deoxynucleotidyl transferase mediated dUTP nick end labeling （TUNEL）. The expressions of Bcl-2 and Bax protein were measured by immunohistochemical technique. Results The serum levels of BUN and Cr at 6h after reperfusion were all significantly higher in group A （P 〈 0.01） and B （P 〈 0.01） than those in group C. Compared with group B the serum levels of BUN and Cr were decreased significantly in group A （P 〈 0.05）. Compared with group C AI （P 〈 0.01） and the expression of Bax （P 〈 0.01） and Bcl-2 （P 〈 0.01） were significantly increased both in group A （P 〈 0.01） and B （P 〈 0.01）; and the Bcl-2/Bax ratio was decreased significantly in group B （P 〈 0.01） and increased in group A （P 〈 0.01）. Compared with group B, AI （P 〈0.05） and the expression of Bax（P 〈 0.05） were decreased significantly in group A,the expression of Bcl-2 （P 〈 0.05） and the Bcl-2/Bax ratio （P 〈 0. 01） were increased significantly. Conclusion Ulinastatin can protect kidney from reperfusion injury after hemorrhagic shock, which may be related to the inhibition of cell apoptosis by regulating the expressions of Bcl-2 and Bax.