Andrews P M, Coffey A K
Lab Invest. 1983 Jul;49(1):87-98.
Rat kidneys were flushed in situ with selected preservation solutions prior to clamping the renal vessels for 1 hour. Collins and Euro-Collins flushing solutions did not appear to protect the physiologic or morphologic status of rat kidneys when examined 2 days after the ischemic insult. These experimental groups exhibited serum creatinine levels similar to those seen in ischemic controls, correspondingly low urine creatinine levels, anuria, and significant deterioration of the uriniferous tubules as revealed by light and electron microscopy. In situ flushing with hypertonic Sacks or isotonic phosphate-buffered sucrose solutions, however, resulted in significant improvements in serum and urine creatinine levels, prevented anuria, and dramatically improved the morphologic integrity of the uriniferous tubules. Flushing with a phosphate-buffered sucrose solution that contained ATP-MgCl2 further improved the physiologic and morphologic status of ischemic kidneys to the point that they were indistinguishable from the nonischemic controls. The degree of protection obtained by flushing kidneys with the isotonic phosphate-buffered sucrose solution plus ATP-MgCl2 is greater than that provided by any other single pretreatment or posttreatment for ischemia that is currently available. We, therefore, believe that the use of this procedure can provide a valuable approach to surgical situations in which postischemic acute renal failure is a potential problem.
在夹闭肾血管1小时之前，用选定的保存溶液对大鼠肾脏进行原位冲洗。在缺血损伤2天后检查时，柯林斯溶液和欧洲柯林斯冲洗溶液似乎并未保护大鼠肾脏的生理或形态状态。这些实验组的血清肌酐水平与缺血对照组相似，尿肌酐水平相应较低，无尿，并且光镜和电镜检查显示肾小管有明显恶化。然而，用高渗的萨克斯溶液或等渗的磷酸盐缓冲蔗糖溶液进行原位冲洗，可使血清和尿肌酐水平显著改善，防止无尿，并显著改善肾小管的形态完整性。用含有ATP - MgCl₂的磷酸盐缓冲蔗糖溶液冲洗可进一步改善缺血肾脏的生理和形态状态，使其与非缺血对照组难以区分。用等渗的磷酸盐缓冲蔗糖溶液加ATP - MgCl₂冲洗肾脏所获得的保护程度大于目前可用的任何其他针对缺血的单一预处理或后处理方法。因此，我们认为，采用该程序可为存在缺血后急性肾衰竭潜在问题的手术情况提供一种有价值的方法。
