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[早期补充外源性左旋肉碱对严重烫伤大鼠肾功能的影响]

[Effects of early supplement of exogenous L-carnitine on renal function in severely scalded rats].

作者信息

Tian X X, Kong W C, Li P T, Xia Z G, Xu J G, Xu Q L

机构信息

Department of Burn Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.

Department of Burns and Plastic Surgery, the Fourth Affiliated Hospital of Anhui Medical University, Hefei 230022, China.

出版信息

Zhonghua Shao Shang Za Zhi. 2020 Jul 20;36(7):553-559. doi: 10.3760/cma.j.cn501120-20200203-00038.

Abstract

To explore the effects of early exogenous L-carnitine supplementation on renal function in severely scalded rats. According to the random number table, sixty-six adult female Sprague-Dawly rats were divided into healthy control group (=6), scald alone group (=30), and scald+ carnitine group (=30). In the latter two groups, the rats were inflicted with full-thickness scald of 30% total body surface area on the back, and the lactated Ringer's solution was injected through the tail vein for resuscitation immediately after scald. At post injury hour (PIH) 1, rats in scald+ carnitine group were intraperitoneally injected with 100 mg/mL L-carnitine solution 400 mg/kg, while rats in scald alone group were intraperitoneally injected with the same volume of normal saline. Rats in these two groups were injected once every 24 hours thereafter. Six rats were taken from each of scald alone group and scald+ carnitine group to collect the renal tissue and abdominal aorta blood at PIH 6, 12, 24, 48, and 72, respectively. The serum content of total protein, albumin, urea nitrogen, creatinine, and cystatin C were determined by the automatic biochemical analyzer. Renal tissue was stained with hematoxylin-eosin to observe histopathological changes. Rats in healthy control group did not undergo any treatment, and their renal tissue and blood sample were extracted and analyzed in the same way as those of severely scalded rats. Data were statistically analyzed with one-way analysis of variance and Bonferroni method. (1) The serum content of total protein and albumin of rats in scald alone group at each time point after injury was significantly lower than that in healthy control group (<0.05). The serum content of total protein of rats in scald+ carnitine group was significantly higher than that in scald alone group at PIH 12 and 24 (<0.05), and the serum content of albumin of rats in scald+ carnitine group was significantly higher than that in scald alone group at PIH 12 (<0.05). The serum content of total protein and albumin of rats in scald alone group and scald+ carnitine group showed a trend of decrease followed by an increase, with the lowest value at PIH 24. (2) The serum content of urea nitrogen and creatinine of rats in scald alone group at each time point after injury was significantly higher than that of healthy control group (<0.05). The serum content of urea nitrogen of rats in scald+ carnitine group was significantly lower than that in scald alone group at PIH 6, 48, and 72 (<0.05). The serum content of creatinine of rats in scald+ carnitine group was significantly lower than that in scald alone group at PIH 12, 24, 48, and 72 (<0.05). The serum content of urea nitrogen and creatinine of rats in scald alone group and scald+ carnitine group showed a trend of increase followed by a decrease, with the peak value at PIH 12. (3) The serum content of cystatin C of rats in scald alone group at PIH 6, 12, 24, 48, and 72 was (0.250±0.030), (0.330±0.070), (0.300±0.060), (0.240±0.060), and (0.190±0.030) mg/L, and the content at the first 4 time points were significantly higher than (0.170±0.020) mg/L of healthy control group (<0.05). At PIH 24, the serum content of cystatin C of rats in scald+ carnitine group was (0.210±0.040) mg/L, which was significantly lower than that of scald alone group (<0.05). The serum content of cystatin C of rats in scald alone group and scald+ carnitine group showed a trend of increase followed by a decrease, with the peak value at PIH 12. (4) The renal tissue of rats in healthy control group was almost normal, and the degree of renal tissue injury of rats in scald+ carnitine group was lighter than that in scald alone group at each time point after injury. At PIH 24, the renal tissue of rats in scald alone group showed extensive swelling of the renal tubular epithelial cells, vacuolar degeneration and necrosis, loss of brush borders, and nuclear shrinkage; more than 2/3 of the renal tubular cell nuclei disappeared, the tubular lumen was narrowed, necrotic exfoliated cells could be seen in the lumen, and edema and inflammatory cell infiltration could be seen in the renal interstitial. Compared with those of scald alone group, significantly reduced severity of edema and necrosis of renal tubular epithelial cells, as well as less inflammatory cell infiltration were observed in the renal tissue of rats in scald+ carnitine group. Early supplement of L-carnitine in severely scalded rats can reduce the damage of renal cells, accelerate the restoration of the content of total protein, albumin, urea nitrogen, creatinine, and cystatin C, thereby maintaining the stability of renal function metabolism level.

摘要

探讨早期外源性补充L-肉碱对严重烫伤大鼠肾功能的影响。将66只成年雌性Sprague-Dawly大鼠按随机数字表法分为健康对照组(n = 6)、单纯烫伤组(n = 30)和烫伤+肉碱组(n = 30)。后两组大鼠背部行30%体表面积的全层烫伤,烫伤后立即经尾静脉注射乳酸林格氏液进行复苏。伤后1小时(PIH 1),烫伤+肉碱组大鼠腹腔注射100 mg/mL L-肉碱溶液400 mg/kg,单纯烫伤组大鼠腹腔注射等体积的生理盐水。此后两组大鼠均每24小时注射1次。分别于PIH 6、12、24、48和72时,从单纯烫伤组和烫伤+肉碱组各取6只大鼠采集肾组织和腹主动脉血。用自动生化分析仪测定血清总蛋白、白蛋白、尿素氮、肌酐和胱抑素C含量。肾组织行苏木精-伊红染色观察组织病理学变化。健康对照组大鼠未进行任何处理,其肾组织和血样的提取及分析方法与严重烫伤大鼠相同。数据采用单因素方差分析和Bonferroni法进行统计学分析。(1)伤后各时间点单纯烫伤组大鼠血清总蛋白和白蛋白含量均显著低于健康对照组(P < 0.05)。烫伤+肉碱组大鼠血清总蛋白含量在PIH 12和24时显著高于单纯烫伤组(P < 0.05),烫伤+肉碱组大鼠血清白蛋白含量在PIH 12时显著高于单纯烫伤组(P < 0.05)。单纯烫伤组和烫伤+肉碱组大鼠血清总蛋白和白蛋白含量呈先降低后升高趋势,在PIH 24时最低。(2)伤后各时间点单纯烫伤组大鼠血清尿素氮和肌酐含量均显著高于健康对照组(P < 0.05)。烫伤+肉碱组大鼠血清尿素氮含量在PIH 6、48和72时显著低于单纯烫伤组(P < 0.05)。烫伤+肉碱组大鼠血清肌酐含量在PIH 12、24、48和72时显著低于单纯烫伤组(P < 0.05)。单纯烫伤组和烫伤+肉碱组大鼠血清尿素氮和肌酐含量呈先升高后降低趋势,在PIH 12时达到峰值。(3)单纯烫伤组大鼠PIH 6、12、24、48和72时血清胱抑素C含量分别为(0.250±0.030)、(0.330±0.070)、(0.300±0.060)、(0.240±0.060)和(0.190±0.030)mg/L,前4个时间点的含量均显著高于健康对照组的(0.170±0.020)mg/L(P < 0.05)。PIH 24时,烫伤+肉碱组大鼠血清胱抑素C含量为(0.210±0.040)mg/L,显著低于单纯烫伤组(P < 0.05)。单纯烫伤组和烫伤+肉碱组大鼠血清胱抑素C含量呈先升高后降低趋势,在PIH 12时达到峰值。(4)健康对照组大鼠肾组织基本正常,伤后各时间点烫伤+肉碱组大鼠肾组织损伤程度均轻于单纯烫伤组。PIH 24时,单纯烫伤组大鼠肾组织可见肾小管上皮细胞广泛肿胀、空泡变性及坏死,刷状缘消失,细胞核固缩;超过2/3的肾小管细胞核消失,管腔狭窄,管腔内可见坏死脱落细胞,肾间质可见水肿及炎性细胞浸润。与单纯烫伤组相比,烫伤+肉碱组大鼠肾组织肾小管上皮细胞水肿及坏死程度明显减轻,炎性细胞浸润也较少。严重烫伤大鼠早期补充L-肉碱可减轻肾细胞损伤,加速总蛋白、白蛋白、尿素氮、肌酐及胱抑素C含量的恢复,从而维持肾功能代谢水平的稳定。

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