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挤压综合征兔模型中两种复苏液体溶液的比较。

Comparison of two fluid solutions for resuscitation in a rabbit model of crush syndrome.

作者信息

Kong De-yang, Hao Li-rong, Zhang Li, Li Qing-gang, Zhou Jian-hui, Shi Suo-zhu, Zhu Fei, Geng Yan-qiu, Chen Xiang-mei

机构信息

Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center of Kidney Diseases, Beijing, China.

Department of Nephrology, 1st Affiliated Hospital of Harbin Medical University, Harbin, China.

出版信息

Clin Exp Nephrol. 2015 Dec;19(6):1015-23. doi: 10.1007/s10157-015-1114-2. Epub 2015 Apr 25.

Abstract

BACKGROUND

Crush syndrome is a common injury, the main characteristics of which include acute kidney injury. However, there is still lack of reliable animal model of crush syndrome, and it also remains controversial as to which type of fluid should be chosen as a more appropriate treatment option for prevention and treatment of acute kidney injury.

METHODS

The rabbits were crushed at the lower limbs for 6 h with 36 times the body weight, which means the pressure of each leg was also 36 times the body weight. Fluid resuscitation was performed from 1 h prior to the end of the crush treatment until 24 h after the reperfusion. Tissue, blood and urine samples were collected at predetermined time points before and after reperfusion. Twelve rabbits in each group were taken for survival observation for 72 h.

RESULTS

The model group showed elevated serum creatine kinase, aspartate aminotransferase, alanine aminotransferase, and K(+) level, reduced serum Ca(2+) level and Na(+) level, and increased serum creatinine and blood urea nitrogen levels, neutrophil gelatinase-associated lipocalin, and kidney injury molecule-1 (p < 0.05). The 0.9 % normal saline (SAL) group and SAL plus 6 % hydroxyethyl starch 130/0.4 SAL/HES group showed reduced serum creatinine and blood urea nitrogen levels (p < 0.05). The SAL/HES group also showed reduced serum IL-6 and IL-10 levels (p < 0.05). The 72 h survival rate of the SAL/HES group was higher than that of the model group (p < 0.05).

CONCLUSION

The rabbit model of crush syndrome showed clinical features consistent with those of crush syndrome. There was no significant difference in the ability of preventing AKI after a crush injury between the two fluid solutions, while SAL/HES can improve the survival rate.

摘要

背景

挤压综合征是一种常见损伤,其主要特征包括急性肾损伤。然而,目前仍缺乏可靠的挤压综合征动物模型,对于选择哪种类型的液体作为预防和治疗急性肾损伤的更合适治疗方案也仍存在争议。

方法

对兔子下肢施加相当于其体重36倍的压力持续6小时,即每条腿的压力也为体重的36倍。在挤压治疗结束前1小时至再灌注后24小时进行液体复苏。在再灌注前后的预定时间点采集组织、血液和尿液样本。每组12只兔子进行72小时的存活观察。

结果

模型组血清肌酸激酶、天冬氨酸氨基转移酶、丙氨酸氨基转移酶和钾离子水平升高,血清钙离子和钠离子水平降低,血清肌酐和血尿素氮水平、中性粒细胞明胶酶相关脂质运载蛋白和肾损伤分子-1升高(p<0.05)。0.9%生理盐水(SAL)组和SAL加6%羟乙基淀粉130/0.4(SAL/HES)组血清肌酐和血尿素氮水平降低(p<0.05)。SAL/HES组血清白细胞介素-6和白细胞介素-10水平也降低(p<0.05)。SAL/HES组72小时存活率高于模型组(p<0.05)。

结论

挤压综合征兔模型表现出与挤压综合征一致的临床特征。两种液体溶液在挤压伤后预防急性肾损伤的能力上无显著差异,而SAL/HES可提高存活率。

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