Department of Emergency Medicine, Research Institute of Clinical Medicine of Jeonbuk National University, Jeonju, Jeollabuk‑do 54907, Republic of Korea.
College of Veterinary Medicine and Biosafety Research Institute, Jeonbuk National University, Iksan, Jeollabuk‑do 54596, Republic of Korea.
Mol Med Rep. 2022 Jan;25(1). doi: 10.3892/mmr.2021.12535. Epub 2021 Nov 19.
Although multi‑organ dysfunction is associated with the survival rate following cardiac arrest (CA), the majority of studies to date have focused on hearts and brains, and few studies have considered renal failure. The objective of the present study, therefore, was to examine the effects of therapeutic hypothermia on the survival rate, pathophysiology and antioxidant enzymes in rat kidneys following asphyxial CA. Rats were sacrificed one day following CA. The survival rate, which was estimated using Kaplan‑Meier analysis, was 42.9% one day following CA. However, hypothermia, which was induced following CA, significantly increased the survival rate (71.4%). In normothermia rats with CA, the serum blood urea nitrogen level was significantly increased one day post‑CA. In addition, the serum creatinine level was significantly increased one day post‑CA. However, in CA rats exposed to hypothermia, the levels of urea nitrogen and creatinine significantly decreased following CA. Histochemical staining revealed a significant temporal increase in renal injury after the normothermia group was subjected to CA. However, renal injury was significantly decreased in the hypothermia group. Immunohistochemical analysis of the kidney revealed a significant decrease in antioxidant enzymes (copper‑zinc superoxide dismutase, manganese superoxide dismutase, glutathione peroxidase and catalase) with time in the normothermia group. However, in the hypothermia group, these enzymes were significantly elevated following CA. Collectively, the results revealed that renal dysfunction following asphyxial CA was strongly associated with the early survival rate and therapeutic hypothermia reduced renal injury via effective antioxidant mechanisms.
虽然多器官功能障碍与心脏骤停 (CA) 后的生存率相关,但迄今为止的大多数研究都集中在心脏和大脑上,很少有研究考虑到肾衰竭。因此,本研究的目的是研究亚低温对窒息性 CA 后大鼠肾脏生存率、病理生理学和抗氧化酶的影响。大鼠在 CA 后一天被处死。使用 Kaplan-Meier 分析估计的生存率在 CA 后一天为 42.9%。然而,CA 后诱导的低温显著提高了生存率(71.4%)。在 CA 后的正常体温大鼠中,血清血尿素氮水平在 CA 后一天显著升高。此外,血清肌酐水平在 CA 后一天显著升高。然而,在接受低温的 CA 大鼠中,CA 后尿素氮和肌酐水平显著降低。组织化学染色显示,正常体温组大鼠接受 CA 后,肾脏损伤呈明显的时间性增加。然而,低温组的肾脏损伤明显减少。肾脏的免疫组织化学分析显示,正常体温组抗氧化酶(铜锌超氧化物歧化酶、锰超氧化物歧化酶、谷胱甘肽过氧化物酶和过氧化氢酶)随时间呈显著下降趋势。然而,在低温组中,这些酶在 CA 后显著升高。综上所述,研究结果表明,窒息性 CA 后的肾功能障碍与早期生存率密切相关,而低温治疗通过有效的抗氧化机制减轻了肾脏损伤。