吳文峰++++++寧雪++++++堯永華

[摘要] 目的 觀察大鼠右美托咪定預(yù)處理后對(duì)肝臟缺血再灌注后急性腎損傷的的保護(hù)作用。 方法 SD雄性大鼠30只，體重220～300 g，隨機(jī)分為3組：對(duì)照組（S組）、肝臟缺血再灌注組（IR組）、右美托咪定組（Dex組）。S組和IR組以1 mL/（kg·h）的速度靜滴生理鹽水30 min，Dex組給予右美托咪定（6 μg/kg）30 min。間隔2 h后S組僅開腹；IR組和Dex組行肝臟缺血60 min，于再灌注4 h后處死大鼠。測(cè)定血清尿素氮（BUN），肌酐（Cr）和腎組織腫瘤壞死因子-α（TNF-α）的濃度，髓過氧化物酶（MPO）、超氧化物歧化酶（SOD）活性及丙二醛（MDA）含量。取腎組織，光鏡下觀察病理學(xué)改變。 結(jié)果 研究中測(cè)得IR組血清BUN為（7.58±0.96）mmol/L、Cr為（91.84±10.34）mmol/L，腎組織TNF-α為（238.4±42.7）ng/L、MDA為（3.66±0.95）U/mg prot、SOD為（7.48±1.23）U/mg prot和MPO為（4.73±1.07）U/g。與S組和Dex組比較，IR組血清BUN和Cr的濃度明顯升高，差異有統(tǒng)計(jì)學(xué)意義（P < 0.05），腎組織TNF-α、MDA水平和MPO活性明顯升高，差異有統(tǒng)計(jì)學(xué)意義（P < 0.05），SOD活性明顯下降，差異有統(tǒng)計(jì)學(xué)意義（P < 0.05）。Dex組與S組比較，血清BUN、Cr和腎組織TNF-α、MDA、SOD和MPO活性的差異均無(wú)統(tǒng)計(jì)學(xué)意義（P > 0.05）。Dex組腎組織病理?yè)p傷程度與IR組比較明顯減輕。 結(jié)論 右美托咪定預(yù)處理能減輕大鼠肝臟缺血再灌注后的急性腎損傷，其機(jī)制可能與抑制炎性因子的分泌，減少氧化應(yīng)激和中性粒細(xì)胞在腎臟的聚集等有關(guān)。

[關(guān)鍵詞] 右美托咪定；肝臟；預(yù)處理；缺血再灌注；腎損傷

[中圖分類號(hào)] R614 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1673-7210（2014）01（c）-0017-03

Effects of Dexmedetomidine preconditioning on acute kidney injury induced by hepatic ischemic-reperfusion

WU Wenfeng NING Xue YAO Yonghua

Department of Anesthesiology， Cancer Hospital of Guangzhou Medical University， Guangdong Province， Guangzhou 510095， China

[Abstract] Objective To investigate the effects of dexmedetomidine preconditioning on acute kidney injury induced by hepatic ischemic-reperfusion. Methods 30 male SD rats weighing 220-300 g were randomly divided into 3 groups（n=10 each）： control group （group S）；ischemic-reperfusion group （group IR） and Dexmedetomidine group （group Dex）. Group S and group IR were injected saline 1mL/（kg·h） for 30 min，Dex group were injectived Dexmedetomidine 6 μg/kg for 30 min. 2 h later， IR group and Dex group animals were administrated hepatic ischemic 60 min. Then， these rats were killed after reperfusion 4 h. The content of serum BUN， Cr and the renal TNF-α， MPO， SOD， MDA were examined. The renal tissue was obtained for microscopic examination. Results In IR group， the concentration of serum BUN and Cr were （7.58±0.96） mmol/L and （91.84±10.34） mmol/L. Renal TNF-α was （238.4±42.7） ng/L， MDA was （3.66±0.95） U/mg prot， SOD was （7.48±1.23） U/mg prot and MPO was （4.73±1.07） U/g. Compared with group S and Dex， the concentration of serum BUN and Cr， renal TNF-α， MDA content and MPO activity significantly increased in IR group， the differences were statistically significant （P < 0.05）. But， renal SOD activity was significantly lower in IR group， the differences were statistically significant （P < 0.05）. Compared with group S， the concentration of serum BUN， Cr， renal TNF-α， MPO content and SOD， MDA activities were no difference in Dex group， the difference was not statistically significant （P > 0.05）. Conclusion Dexmedetomidine preconditioning can reduce acute kidney injury induced by hepatic ischemic-reperfusion through inhibition of TNF-a release and reducing neutrophil infiltration and oxygen radical in renal tissue.endprint