Zhao Shen, Tang Ziren, Cui Hao, Yang Zhengfei, Shao Fei, Wang Shuo, Chen Feng
Shengli Clinical Medical College, Fujian Medical University, Fuzhou 350001, China.
Department of Emergency Medicine, Fujian Provincial Hospital, Fujian Institute of Emergency Research, Fuzhou 350001, China.
Evid Based Complement Alternat Med. 2020 Apr 22;2020:3789268. doi: 10.1155/2020/3789268. eCollection 2020.
To comprehensively evaluate the protective effect of Shenfu injection (SFI) on renal ischaemia/reperfusion injury (IRI) after cardiopulmonary resuscitation (CPR) through neutrophil gelatinase-associated lipocalin (NGAL) and to explore effective monitoring of early renal injuries after CPR.
Thirty healthy minipigs were randomly divided into 3 groups: sham operation (SO) ( = 6), control ( = 12), and SFI ( = 12). The SO group underwent only catheterization, whereas the control and SFI groups were subjected to program-controlled electrical stimulation to establish a cardiac arrest (CA) model due to ventricular fibrillation. After CPR, the return of spontaneous circulation was achieved. Each animal in the SFI group was intravenously injected with SFI after resuscitation. Haemodynamic parameters were monitored at baseline and 2, 6, 12, and 24 hr after CPR. At each time point, venous blood samples were collected for NGAL, creatinine, and ATPase screening.
After CA, the MAP, CPP, and CO of the animals in the control and SFI groups decreased significantly. However, at 6 hr after CPR, the MAP, CPP, and CO of the animals in the SFI group began to recover gradually; the differences between the control and SFI groups were significant ( < 0.005). The renal damage immediately after CPR appeared to be significant in the pathological examinations. However, the degree of renal injury in the SFI group improved significantly, and the apoptosis index was also notably reduced. The blood and urine NGAL levels were clearly elevated after CPR. The greatest increase in NGAL was found in the control group, which was significantly different from that of the SFI group ( < 0.001). SFI can significantly increase the ATPase activity of kidney tissues after CPR and improve abnormal caspase-3 protein expression.
SFI can effectively prevent acute kidney injuries caused by CPR through improving energy metabolism and inhibiting apoptosis.
通过中性粒细胞明胶酶相关脂质运载蛋白（NGAL）全面评估参附注射液（SFI）对心肺复苏（CPR）后肾脏缺血/再灌注损伤（IRI）的保护作用，并探索对CPR后早期肾脏损伤的有效监测。
将30只健康小型猪随机分为3组：假手术（SO）组（n = 6）、对照组（n = 12）和SFI组（n = 12）。SO组仅进行插管，而对照组和SFI组接受程控电刺激以建立心室颤动导致的心脏骤停（CA）模型。CPR后实现自主循环恢复。SFI组的每只动物在复苏后静脉注射SFI。在CPR前及CPR后2、6、12和24小时监测血流动力学参数。在每个时间点，采集静脉血样本进行NGAL、肌酐和ATP酶筛查。
CA后，对照组和SFI组动物的平均动脉压（MAP）、脑灌注压（CPP）和心输出量（CO）显著下降。然而，CPR后6小时，SFI组动物的MAP、CPP和CO开始逐渐恢复；对照组和SFI组之间的差异具有显著性（P < 0.005）。CPR后立即进行的病理检查显示肾脏损伤明显。然而，SFI组的肾脏损伤程度显著改善，凋亡指数也明显降低。CPR后血液和尿液中的NGAL水平明显升高。对照组中NGAL的升高幅度最大，与SFI组有显著差异（P < 0.001）。SFI可显著增加CPR后肾脏组织的ATP酶活性，并改善异常的半胱天冬酶-3蛋白表达。
SFI可通过改善能量代谢和抑制细胞凋亡有效预防CPR所致的急性肾损伤。
