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糖皮质激素对肾毒性的改善作用:头孢噻啶与甲基强的松龙在大鼠体内相互作用的研究

Glucocorticoid amelioration of nephrotoxicity: a study of cephaloridine-methylprednisolone interaction in the rat.

作者信息

Harvey P W, Healing G, Major I R, McFarlane M, Purdy K A, Olatunde O, Garcia Conesa M T, Everett D J, Cockburn A

机构信息

AgrEvo UK Limited, Toxicology, Essex, UK.

出版信息

Hum Exp Toxicol. 1995 Jul;14(7):554-61. doi: 10.1177/096032719501400702.

Abstract

Groups of ten male rats were treated with a high challenge dose of cephaloridine (CPH, 3750 mg kg-1), with methylprednisolone (MP, 100 mg kg-1) or with cephaloridine and methylprednisolone (CPH + MP) by single subcutaneous injection. A control group received the injection vehicles only. Urine was collected from all animals daily over 18-h collection periods, up to 96 h after treatment. Blood was collected at 24, 48, 72 and 96 h after treatment. At necropsy, kidneys were weighed, processed and examined histopathologically. Results show that methylprednisolone significantly ameliorated the nephrotoxicity of the challenge dose of cephaloridine. CPH-only treated rats had severe toxic nephrosis characterised by acute tubular necrosis, and elevated blood urea and creatinine. By contrast, the majority of CPH + MP treated rats had only a slight or moderate toxic nephrosis, and had lower blood urea and creatinine levels compared with rats treated with CPH only, indicating preservation of kidney function. Interestingly, rats treated with CPH + MP had higher urinary enzymes (alkaline phosphatase, lactate dehydrogenase, gamma glutamyltransferase and N-acetyl-beta-glucosaminidase) as well as protein and glucose, compared with rats treated with CPH only. This is taken to indicate that rats treated with CPH only had such marked kidney damage and necrosis that the population of cells able to produce these marker enzymes was significantly and rapidly depleted, but the protection afforded by methylprednisolone allowed CPH + MP treated rats to sustain urinary enzyme output. Effects on urinary glucose and other parameters such as body weight and kidney weight demonstrate interactions between glucocorticoid pharmacology and cephaloridine nephrotoxicity.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

将十只雄性大鼠分为几组,通过单次皮下注射给予高剂量的头孢菌素(CPH,3750毫克/千克)、甲基强的松龙(MP,100毫克/千克)或头孢菌素与甲基强的松龙(CPH + MP)。对照组仅接受注射载体。在治疗后长达96小时的时间里,每天在18小时的收集期内收集所有动物的尿液。在治疗后24、48、72和96小时采集血液。尸检时,称量肾脏重量,进行处理并进行组织病理学检查。结果表明,甲基强的松龙显著改善了高剂量头孢菌素的肾毒性。仅接受CPH治疗的大鼠出现严重的中毒性肾病,其特征为急性肾小管坏死,血尿素和肌酐升高。相比之下,大多数接受CPH + MP治疗的大鼠仅有轻度或中度中毒性肾病,与仅接受CPH治疗的大鼠相比,其血尿素和肌酐水平较低,表明肾功能得到了保留。有趣的是,与仅接受CPH治疗的大鼠相比,接受CPH + MP治疗的大鼠尿液中的酶(碱性磷酸酶、乳酸脱氢酶、γ-谷氨酰转移酶和N-乙酰-β-葡萄糖苷酶)以及蛋白质和葡萄糖含量更高。这表明仅接受CPH治疗的大鼠肾脏损伤和坏死非常明显,能够产生这些标记酶的细胞数量显著且迅速减少,但甲基强的松龙提供的保护使接受CPH + MP治疗的大鼠能够维持尿液酶的输出。对尿液葡萄糖以及体重和肾脏重量等其他参数的影响表明了糖皮质激素药理学与头孢菌素肾毒性之间的相互作用。(摘要截断于250字)

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