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含利多卡因的欧洲柯林斯液可预防长时间冷缺血的离体灌注犬肾发生肾损伤。

Lidocaine-containing Euro-Collins solution prevents renal injury in the isolated perfused canine kidney exposed to prolonged cold ischemia.

作者信息

Erkasap N, Ates E, Erkasap S, Kaygisiz Z

机构信息

Department of Physiology, Osmangazi University, Medical Faculty, Eskisehir, Turkey.

出版信息

Physiol Res. 2002;51(5):493-9.

Abstract

Previous studies have reported a decreased incidence of delayed graft function after cadaveric transplantation with the use of lidocaine pretreatment of the donor. We evaluated the effects of lidocaine on prolonged cold ischemia and reperfusion injury in a canine model of isolated kidney perfusion (IPK). The purpose of this study was to evaluate the renal function of isolated perfused canine kidneys after 48 h of cold storage with Euro-Collins (EC) solution or EC solution plus lidocaine. Isolated perfused canine kidneys were randomized into four groups which contained six kidneys: I) cold flush with EC solution and immediately reperfused, II) cold flush with EC solution plus lidocaine and immediately reperfused, III) 48 h of cold storage with EC and reperfusion, IV) 48 h of cold storage with EC solution plus lidocaine and reperfusion. The measured renal functions were glomerular filtration rate, urine production, perfusate flow, urinary lactic dehydrogenase (ULDH), Na reabsorptive capacity, and tissue MDA levels. Histological examination was performed after reperfusion. The tubular functions of kidneys preserved with EC solution containing lidocaine were better when compared with the kidneys preserved with EC alone. Tubular injury marker levels (ULDH) in group IV were significantly lower than in group III and lidocaine also reduced lipid peroxidation during reperfusion. This is in agreement with the histological results. The results of the present study can be taken as evidence of the cytoprotective effect of lidocaine, which may therefore be accepted as a useful agent for kidney preservation.

摘要

先前的研究报道,在尸体肾移植中使用利多卡因预处理供体后,移植肾功能延迟的发生率降低。我们在犬离体肾灌注(IPK)模型中评估了利多卡因对延长冷缺血和再灌注损伤的影响。本研究的目的是评估在Euro - Collins(EC)溶液或EC溶液加利多卡因冷保存48小时后,离体灌注犬肾的肾功能。离体灌注犬肾被随机分为四组,每组六个肾脏:I)用EC溶液冷冲洗并立即再灌注,II)用EC溶液加利多卡因冷冲洗并立即再灌注,III)用EC溶液冷保存48小时后再灌注,IV)用EC溶液加利多卡因冷保存48小时后再灌注。测量的肾功能指标包括肾小球滤过率、尿量、灌注液流量、尿乳酸脱氢酶(ULDH)、钠重吸收能力和组织丙二醛水平。再灌注后进行组织学检查。与单独用EC溶液保存的肾脏相比,用含利多卡因的EC溶液保存的肾脏的肾小管功能更好。IV组的肾小管损伤标志物水平(ULDH)显著低于III组,利多卡因还减少了再灌注期间的脂质过氧化。这与组织学结果一致。本研究结果可作为利多卡因具有细胞保护作用的证据,因此利多卡因可被认为是一种用于肾脏保存的有用药物。

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