Acar Demet, Gülpembe Mustafa, Özdamar Emine Nur
Department of Emergency Medicine, University of Health Sciences Konya City Hospital, Konya-Türkiye.
Department of Medical Pharmacology, Yeditepe University Faculty of Medicine, Istanbul-Türkiye.
Ulus Travma Acil Cerrahi Derg. 2024 Jan;30(12):845-851. doi: 10.14744/tjtes.2024.43316.
This study aims to investigate the impact of combining crush fluid resuscitation with gelsolin treatment on renal function in a rat model of crush syndrome.
Twenty-four adult female Wistar albino rats were randomly assigned to one of three groups for crush syndrome treat-ment: Control (C) group, gelsolin + crush fluid (gel) group, and crush fluid only (CF) group, each containing eight rats. Sedated rats underwent unilateral hind limb compression of 2 kg using a compression device, maintained for five hours. The control group received no treatment post-compression. After removing the tourniquet, rats in the gelsolin group received an intravenous administration of recombinant human gelsolin at a dose of 2 mg/kg in 0.1 ml sterile saline, along with crush fluid. The CF group received only the crush solution.
At 24 hours, creatine kinase (CK) levels in the CF group were lower compared to those in the control and gelsolin + CF groups (132 IU vs. 630 IU [p=0.004] and 519.5 IU [p=0.014], respectively). By 48 hours, CK levels in both CF and gelsolin + CF groups were lower than in the control group (p<0.001 and p=0.014, respectively), with no significant difference between the CF and gelsolin + CF groups (p=0.773). At 72 hours, CK levels in the gelsolin + CF group were lower than in the control group (p=0.023) but comparable to the CF group (p>0.05). Blood urea nitrogen (BUN) levels at 24 and 72 hours were similar in the control and gelsolin + CF groups (p>0.05). At 48 hours, BUN levels in both CF and gelsolin + CF groups were lower than in the control group (p=0.001 and p=0.003, respectively), with no significant difference between the CF and Gelsolin + CF groups (p>0.05). At 24 hours, creatinine levels in the gelsolin + CF group were lower than in the control group (p=0.017), while levels in the CF and gelsolin + CF groups were similar (p>0.05). By 48 and 72 hours, creatinine levels in both CF and gelsolin + CF groups were similar but lower than in the control group (p<0.05). Changes in creatinine levels were comparable across all groups (p>0.05).
This study marks the first instance in literature where it has been demonstrated that administering gelsolin along with crush solution does not yield superior results compared to crush solution alone in treating crush syndrome. Nonetheless, further research utilizing varying doses of gelsolin is warranted.
本研究旨在探讨在挤压综合征大鼠模型中，联合使用挤压伤液体复苏与凝溶胶蛋白治疗对肾功能的影响。
将24只成年雌性Wistar白化大鼠随机分为三组进行挤压综合征治疗：对照组（C组）、凝溶胶蛋白+挤压伤液体（凝胶）组和仅挤压伤液体（CF）组，每组8只大鼠。对麻醉的大鼠使用压迫装置对单侧后肢施加2kg压力，持续5小时。对照组在压迫后不进行治疗。去除止血带后，凝胶组大鼠在0.1ml无菌盐水中以2mg/kg的剂量静脉注射重组人凝溶胶蛋白，并给予挤压伤液体。CF组仅接受挤压伤溶液。
24小时时，CF组的肌酸激酶（CK）水平低于对照组和凝溶胶蛋白+CF组（分别为132IU vs. 630IU [p = 0.004]和519.5IU [p = 0.014]）。到48小时时，CF组和凝溶胶蛋白+CF组的CK水平均低于对照组（分别为p < 0.001和p = 0.014），CF组和凝溶胶蛋白+CF组之间无显著差异（p = 0.773）。72小时时，凝溶胶蛋白+CF组的CK水平低于对照组（p = 0.023），但与CF组相当（p > 0.05）。对照组和凝溶胶蛋白+CF组在24小时和72小时时的血尿素氮（BUN）水平相似（p > 0.05）。48小时时，CF组和凝溶胶蛋白+CF组的BUN水平均低于对照组（分别为p = 0.001和p = 0.003），CF组和凝溶胶蛋白+CF组之间无显著差异（p > 0.05）。24小时时，凝溶胶蛋白+CF组的肌酐水平低于对照组（p = 0.017），而CF组和凝溶胶蛋白+CF组的水平相似（p > 0.05）。到48小时和72小时时，CF组和凝溶胶蛋白+CF组的肌酐水平相似但低于对照组（p < 0.05）。所有组的肌酐水平变化相当（p > 0.05）。
本研究是文献中首次证明在治疗挤压综合征时，与单独使用挤压伤溶液相比，联合使用凝溶胶蛋白和挤压伤溶液不会产生更好的效果。尽管如此，仍有必要利用不同剂量的凝溶胶蛋白进行进一步研究。
