Zhao Zi-Gang, Zhu Hong-Xia, Zhang Li-Min, Zhang Yu-Ping, Niu Chun-Yu
Institute of Microcirculation, Hebei North University, Diamond South Road 11, Zhangjiakou, Hebei 075000, China.
ScientificWorldJournal. 2014 Feb 25;2014:720836. doi: 10.1155/2014/720836. eCollection 2014.
This study aimed to investigate the effect of mesenteric lymph drainage on the acute kidney injury induced by hemorrhagic shock without resuscitation. Eighteen male Wistar rats were randomly divided into sham, shock, and drainage groups. The hemorrhagic shock model (40 mmHg, 3 h) was established in shock and drainage groups; mesenteric lymph drainage was performed from 1 h to 3 h of hypotension in the drainage group. The results showed that renal tissue damage occurred; the levels of urea, creatinine, and trypsin in the plasma as well as intercellular adhesion molecule-1 (ICAM-1), receptor of advanced glycation end-products (RAGE), tumor necrosis factor-α (TNF-α), malondialdehyde (MDA), lactic acid (LA), and 2,3-DPG in the renal tissue were increased in the shock group after 3 h of hypotension. Mesenteric lymph drainage lessened the following: renal tissue damage; urea and trypsin concentrations in the plasma; ICAM-1, RAGE, TNF-α, MDA, and LA levels in the renal tissue. By contrast, mesenteric lymph drainage increased the 2,3-DPG level in the renal tissue. These findings indicated that mesenteric lymph drainage could relieve kidney injury caused by sustained hypotension, and its mechanisms involve the decrease in trypsin activity, suppression of inflammation, alleviation of free radical injury, and improvement of energy metabolism.
本研究旨在探讨肠系膜淋巴引流对未复苏失血性休克所致急性肾损伤的影响。将18只雄性Wistar大鼠随机分为假手术组、休克组和引流组。休克组和引流组建立失血性休克模型（40 mmHg，3小时）；引流组在低血压1小时至3小时期间进行肠系膜淋巴引流。结果显示，出现了肾组织损伤；低血压3小时后，休克组血浆中尿素、肌酐和胰蛋白酶水平以及肾组织中细胞间黏附分子-1（ICAM-1）、晚期糖基化终末产物受体（RAGE）、肿瘤坏死因子-α（TNF-α）、丙二醛（MDA）、乳酸（LA）和2,3-二磷酸甘油酸（2,3-DPG）水平升高。肠系膜淋巴引流减轻了以下各项：肾组织损伤；血浆中尿素和胰蛋白酶浓度；肾组织中ICAM-1、RAGE、TNF-α、MDA和LA水平。相比之下，肠系膜淋巴引流增加了肾组织中2,3-DPG水平。这些研究结果表明，肠系膜淋巴引流可缓解持续性低血压所致的肾损伤，其机制包括胰蛋白酶活性降低、炎症抑制、自由基损伤减轻以及能量代谢改善。
