胰岛素抗急性缺血再灌注肾损伤的作用研究

目的 :研究胰岛素 (insulin ,Ins)对家兔急性缺血再灌注性肾损伤的影响。方法 :采用钳夹肾动脉的方法建造急性肾缺血再灌注肾损伤模型。实验动物分为三组 :对照组、单纯缺血再灌注 (IR)组、胰岛素处理 (Ins -IR)组。胰岛素处理组再灌注的同时给予胰岛素溶液 (含Ins 3UI/kg ,葡萄糖 1.5 g/kg ,k+ 0 .4mg/kg) ,对照组和IR组给予等量生理盐水。分别观察三组动物缺血再灌注 2h ,4 8h后 ,血清尿素氮 (BUN)、血糖、血清及肾组织中丙二醛 (MDA)、肾组织一氧化氮 (NO)含量变化 ,以及肾组织超微结构改变。结果 :肾缺血再灌注 4 8h后 ,IR组血清尿素氮较对照组显著升高 (P <0 .0 0 1) ,而Ins-IR组与对照组无显著差异 (P >0 .0 5 ) ;IR组血清及肾组织中MDA含量较对照组显著升高 (P <0 .0 5 ) ,胰岛素处理后MDA含量明显降低 (P <0 .0 5 ) ;缺血再灌注 2h后 ,肾组织中NO含量即明显降低 (P <0 .0 0 1) ,胰岛素处理后 ,NO水平升高至正常水平。缺血再灌注 2h后 ,三组动物血糖均较术前增高 ,但以IR组增高更为显著 ,与对照组比较P <0 .0 5 ,Ins-IR组与对照组无差异。电镜结果显示 ,对照组超微结构正常 ,IR组肾组织呈变性和坏死改变 ,Ins -IR组肾组织轻度变性。结论 :胰岛素具有抗家兔急性缺血再灌注性肾损伤的作用 ,其作用

EFFECTS OF INSULIN ON ACUTE RENAL ISCHEMIC/REPERFUSION INJURY

Objective:To observe the effect of insulin treatment on the kidney with acute ischemic/reperfusion injury in rabbits.Methods:Twenty-seven Japanese white rabbits were allocated randomly into control group, ischemic/reperfusion group(IR group)and insulin treatment group(Ins-IR group). IR group received clamping for 1hour followed by 2 hours or 48 hours of reperfusion. Insulin injection (insulin 3U/kg, glucose 1.5g/kg, k + 4mg/kg) was administered intravenously two times a day for two days consistently to the Ins-IR group ,while only glucose saline in equal amount was administered to IR group and control group similarly. At 2h or 48h after reperfusion, sugar and urea nitrogen(BUN) in serum, MDA in serum and renal tissue ,nitric oxide (NO)in renal tissue were determined; the ultra-structure of renal tissue was observed under electron-microscope.Results: Plasma BUN of IR group was significantly higher than that of control after 48-hour reperfusion( P <0.001);MDA contents in IR group were much higher than that in the control group ( P <0.05);the concentration of NO in renal tissue was much lower than that of control since 2-hour reperfusion ( P <0.001).Treatment with insulin considerably reduced BUN,MDA level in the serum or renal tissue ( P <0.05,compared with IR group ) and greatly increased NO level in renal tissue( P <0.001,compared with IR group);the level of serum sugar increased after 2-hour reperfusion in three groups, but in IR group the value increased much more higher than those in control and Ins-IR groups( P <0.05).In electron-microscope ,the serious degeneration and necrosis of renal tissue were observed in IR group, but only slight degeneration in Ins-IR group.Conclusions:The results indicate that insulin is effective in protecting the kidney from ischemic/reperfusion injury.