目的:利用缺血再灌注急性肾损伤大鼠模型,评价以尿液管型及脱落细胞为基础建立的评分系统是否具有早期预测急性肾损伤的价值.方法:将48只SD大鼠随机分为对照组、假手术组、缺血再灌注损伤组缺血再灌注损伤组动脉夹闭45 min后松开动脉夹并分别再灌注0 h、2 h、6 h、12 h、24 h、48 h,采集各组大鼠的肾脏、血清及尿液标本,使用生化仪检测各时间点大鼠血肌酐情况,HE染色观察肾组织病理损伤程度,尿沉渣分析仪分析各组大鼠尿液管型情况并根据Perezella尿沉渣评分系统进行评分.结果:0h组大鼠血肌酐值为46.50(17.00)μmol/L,6h组大鼠血肌酐值出现明显上升,为174.50(18.25)μmol/L(P=0.049),24 h 达到高峰,为 323.00(91.00)μmol/L(P＜0.001).0 h 组大鼠病理评分为 0.33±0.52,2 h组即出现上升(2.00±0.63,P＜0.001),24 h 达峰值(3.50±0.55,P＜0.001).0 h 组尿液 Perezella 评分为 0.17±0.41,2 h出现上升(2.33±0.52,P＜0.001),24 h组达峰值(3.83±0.41,P＜0.001).结论:病理评分和尿液Perezella评分基本同步,均于缺血再灌注2h出现有意义的上升,而血肌酐有意义的上升出现在再灌注6 h组,尿液管型出现变化时间早于血肌酐,可作为急性肾损伤的早期诊断标志物.
Experimental Study of Perezella Urinary Sediment Scoring System for Early Diagnosis of Acute Kidney Injury
Objective:To evaluate the value of scoring system based on urine tubular type and excluded-cells in early pre-diction of acute kidney injury in rats with ischemia-reperfusion.Methods:Forty-eight SD rats were randomly divided into control group,sham operation group and ischemia-reperfusion injury group(6 groups).The control group was not treated,and the sham operation group was not treated with artery clipping after open nephrotomy.In the ischemia-reperfusion injury group,the artery clip was loosened for 45 min and reperfusion was performed for 0 h,2 h,6 h,12 h,24 h and 48 h,respectively.The kidney,serum and urine samples of rats in each group were collected.The serum creatinine of rats at each time point was detected by biochemical analy-zer,the degree of pathological damage of renal tissue was observed by HE staining,and the urinary tubular pattern of rats in each group was analyzed by urine sediment analyzer and scored.Results:The serum creatinine value of rats in the 0 h group was(43.83± 6.91)μmol/L,the serum creatinine value of rats in the 6 h group was significantly increased to 174.50(18.25)μmol/L(P=0.049),and reached a peak of 323.00(91.00)μmol/L at 24 h(P＜0.001).The pathological score of rats in the 0 h group was 0.33±0.52,and increased to 2.00±0.63 in the 2 h group(P＜0.001),and reached the peak value at 24 h(3.50±0.55,P＜0.001).The urinary tubular score of 0 h group was 0.17±0.41,and increased at 2 h(2.33±0.52,P＜0.001),and reached the peak value at 24 h group(3.83±0.41,P＜0.001).Conclusion:Pathological score and urinary tubular score were basically syn-chronized,and both showed significant increase at 2 h after ischemia reperfusion.A significant increase in serum creatinine occurred at 6h after reperfusion.The change time of urine duct type is earlier than that of serum creatinine,which has a certain value in the early diagnosis of acute kidney injury.
万方数据
维普
