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实验性慢性肾病不同阶段对大鼠运动和姿势骨骼肌微循环的影响。

Influence of different stages of experimental chronic kidney disease on rats locomotor and postural skeletal muscles microcirculation.

作者信息

Flisiński Mariusz, Brymora Andrzej, Elminowska-Wenda Gabriela, Bogucka Joanna, Walasik Konrad, Stefańska Anna, Odrowaz-Sypniewska Grazyna, Manitius Jacek

机构信息

Department of Nephrology, Hypertension and Internal Diseases of Ludwig Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland.

出版信息

Ren Fail. 2008;30(4):443-51. doi: 10.1080/08860220801985694.

Abstract

BACKGROUND

Chronic kidney disease (CKD) is associated with muscle excess fatigue and diminished maximal whole body oxygen consumption, which in part could be depended on poor muscle microcirculatory network. The aim of this study was to assume the influence of different stages of CKD on microcirculation vessels in functionally different skeletal muscles--locomotor, the gastrocnemius muscle, and postural, the longissimus thoracis muscle.

METHODS

Male Wistar rats underwent sham operation (CON), uninephrectomy (CKD 1/2) and subtotal nephrectomy (CKD 5/6). Muscle samples were stained for an alkaline phosphatase to differentiate capillaries. The number of capillaries was estimated by a single observer in 10 microm transverse sections by point counting at a magnification of x 125 using an Image Analysis System Q 500 MC of Leica. Blood pressure and serum creatinine, haptoglobin, MCP-1, VEGF, and PDGF were measured.

RESULTS

There were significant differences (p < 0.05) in CD (number of capillaries per 1 mm(2) of muscle tissue), C:F (capillary to fiber ratio), and CC/F (capillary contact per fiber). The CKD 1/2 group in gastrocnemius and longissimus muscle had 53% and 33% lower C:F; 56% and 33% lower CD; and 44% and 20% less CC/F than CON, respectively. The CKD 5/6 group in gastrocnemius and longissimus muscle had 46% and 20% lower C:F; 47% and 11% lower CD; and 48% and 25% less CC/F versus control, respectively. Blood pressure was higher in CKD 5/6 vs. CKD 1/2 and CON (145/95 vs. 107/87 and 119/77 mmHg, p < 0.05, respectively). CKD 5/6 had higher creatinine than CKD 1/2 and CON (1.22 vs. 0.83 and 0.74 mg/dL, p < 0.05, respectively). Haptoglobin was higher in CKD 1/2 and CKD 5/6 versus CON (1.68 and 1.63 vs. 0.70 mg/mL, p < 0.05, respectively). MCP-1 was higher in CKD 5/6 and CKD 1/2 versus CON (609 and 489 vs. 292 pg/mL, p < 0.05, respectively). There were no significant differences in serum growth factors concentration between groups.

CONCLUSION

Capillary rarefaction is present in early stages of CKD. These changes are independent of blood pressure and progression of CKD. We suspected that muscle function has a big impact on microvasculature as capillaries rarefaction has been reduced more in locomotor than postural skeletal muscle.

摘要

背景

慢性肾脏病(CKD)与肌肉过度疲劳及全身最大耗氧量降低有关,这部分可能取决于肌肉微循环网络不佳。本研究的目的是推测CKD不同阶段对功能不同的骨骼肌——运动肌腓肠肌和姿势肌胸最长肌的微血管的影响。

方法

雄性Wistar大鼠接受假手术(CON)、单侧肾切除术(CKD 1/2)和次全肾切除术(CKD 5/6)。肌肉样本用碱性磷酸酶染色以区分毛细血管。由一名观察者使用徕卡Q 500 MC图像分析系统在125倍放大倍数下通过点计数法在10微米横切面上估计毛细血管数量。测量血压以及血清肌酐、触珠蛋白、单核细胞趋化蛋白-1(MCP-1)、血管内皮生长因子(VEGF)和血小板衍生生长因子(PDGF)。

结果

在每平方毫米肌肉组织的毛细血管数量(CD)、毛细血管与纤维比率(C:F)以及每根纤维的毛细血管接触数(CC/F)方面存在显著差异(p < 0.05)。CKD 1/2组腓肠肌和胸最长肌的C:F分别比CON组低53%和33%;CD分别低56%和33%;CC/F分别少44%和20%。CKD 5/6组腓肠肌和胸最长肌的C:F分别比对照组低46%和20%;CD分别低47%和11%;CC/F分别少48%和25%。CKD 5/6组的血压高于CKD 1/2组和CON组(分别为145/95 mmHg、107/87 mmHg和119/77 mmHg,p < 0.05)。CKD 5/6组的肌酐高于CKD 1/2组和CON组(分别为1.22 mg/dL、0.83 mg/dL和0.74 mg/dL,p < 0.05)。CKD 1/2组和CKD 5/6组的触珠蛋白高于CON组(分别为1.68 mg/mL、1.63 mg/mL和0.70 mg/mL,p < 0.05)。CKD 5/6组和CKD 1/2组的MCP-1高于CON组(分别为609 pg/mL、489 pg/mL和292 pg/mL,p < 0.05)。各组间血清生长因子浓度无显著差异。

结论

CKD早期存在毛细血管稀疏。这些变化与血压及CKD进展无关。我们推测肌肉功能对微血管系统有很大影响,因为运动骨骼肌的毛细血管稀疏比姿势骨骼肌减少得更多。

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