Whitley D, Patterson R, Greenburg A G
Brown University School of Medicine, Providence, Rhode Island, 02912, USA.
J Surg Res. 1998 Jul 1;77(2):187-91. doi: 10.1006/jsre.1998.5375.
The purpose of this study is to determine whether an infusion of polymerized hemoglobin solution is capable of suppressing the tubular damage and loss of renal function normally seen during a clinically relevant period of warm ischemia.
Male rats (350-450 g) were randomized to treatment with control (5% human serum albumin, HSA, n = 6) or test solution (9% polymerized hemoglobin, PHB, n = 6). Following a right nephrectomy, the left renal artery was perfused with 4 ml of HSA or PHB at 37 degreesC. The left renal artery was temporarily occluded for 50 min. At 72 h, creatinine (Cr), blood urea nitrogen (BUN), and percentage hemoglobin (Hb) were measured and the kidney was removed. Stained kidney sections were graded for ischemic injury (0-4, 0 = normal and 4 = necrosis of the proximal tubule). All results were expressed as means +/- SEM and statistical analysis was performed by t test.
Treatment with PHB resulted in lower Cr (1.2 +/- 0.23 mg/dl vs 3.26 +/- 0.60 mg/dl, P < 0.01) and BUN (60.5 +/- 12.7 mg/dl vs 151 +/- 20.2 mg/dl, P < 0.01) at 72 h compared to HSA controls. Total hemoglobin was not significantly different at 72 h. The weight of all treated kidneys increased; however, the increase was significantly less in the PHB-treated group (34 +/- 9.1% vs 70 +/- 7. 4%, P < 0.01). PHB-treated kidneys had less evidence of histologic damage compared to those in the HSA group (0.75 +/- 0.11 vs 2.50 +/- 0.64, P < 0.05).
During normothermic renal ischemia, renal artery infusion of PHB resulted in preservation of renal function and histologic architecture. PHB solutions may be useful in preserving organ function during prolonged periods of in vivo ischemia.
本研究的目的是确定输注聚合血红蛋白溶液是否能够抑制在临床相关的热缺血期间通常出现的肾小管损伤和肾功能丧失。
将雄性大鼠（350 - 450克）随机分为对照组（5%人血清白蛋白，HSA，n = 6）或测试溶液组（9%聚合血红蛋白，PHB，n = 6）进行治疗。右肾切除术后，在37℃下用4毫升HSA或PHB灌注左肾动脉。左肾动脉暂时阻断50分钟。在72小时时，测量肌酐（Cr）、血尿素氮（BUN）和血红蛋白百分比（Hb），并切除肾脏。对染色的肾脏切片进行缺血损伤分级（0 - 4级，0 = 正常，4 = 近端小管坏死）。所有结果均以平均值±标准误表示，并通过t检验进行统计分析。
与HSA对照组相比，在72小时时，用PHB治疗导致较低的Cr（1.2±0.23毫克/分升对3.26±0.60毫克/分升，P < 0.01）和BUN（60.5±12.7毫克/分升对151±20.2毫克/分升，P < 0.01）。在72小时时总血红蛋白无显著差异。所有治疗组的肾脏重量均增加；然而，PHB治疗组的增加显著较少（34±9.1%对70±7.4%，P < 0.01）。与HSA组相比，PHB治疗的肾脏组织学损伤证据较少（0.75±0.11对2.50±0.64，P < 0.05）。
在常温肾缺血期间，肾动脉输注PHB可导致肾功能和组织结构的保存。PHB溶液可能有助于在体内长时间缺血期间保存器官功能。
