上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2019, Vol. 39 ›› Issue (12): 1360-.doi: 10.3969/j.issn.1674-8115.2019.12.004

• 论著·基础研究 • 上一篇    下一篇

左西孟旦对心搏骤停-心肺复苏后大鼠肾损伤的影响

王世伟1，郭 建1，杨正飞2，陆晓晔1，杨 倩1，朱长清1   

  1. 1. 上海交通大学医学院附属仁济医院急诊科，上海200120；2. 中山大学孙逸仙纪念医院急诊科，广州510120
  • 出版日期:2019-12-28 发布日期:2020-02-06
  • 通讯作者: 朱长清，电子信箱：zhucq1965@126.com。
  • 作者简介:王世伟（1990—），男，硕士生；电子信箱：wangsw1990@126.com。
  • 基金资助:
    国家自然科学基金面上项目（81671881）

Effects of levosimendan on kidney injury in ventricular fibrillation-induced cardiac arrest rats

WANG Shi-wei, GUO Jian, YANG Zheng-fei, LU Xiao-ye, YANG Qian, ZHU Chang-qing   

  1. 1. Department of Emergency, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200120, China; 2. Department of Emergency, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
  • Online:2019-12-28 Published:2020-02-06
  • Supported by:
    National Natural Science Foundation of China, 81671881

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摘要： 目的·探讨左西孟旦对心搏骤停-心肺复苏后大鼠肾损伤的影响。方法·将25只健康成年雄性SD大鼠随机分为左西孟旦干预组（L组，10只）、空白对照组（C组，10只）和假手术组（S组，5只）。L组和C组用心室纤颤（室颤）法建立心搏骤停–心肺复苏动物模型，L组大鼠在复苏期间及复苏后予左西孟旦干预，C组大鼠在复苏期间及复苏后予等剂量生理盐水处理。S组大鼠不进行心搏骤停和心肺复苏操作，予等剂量生理盐水处理。比较L组和C组大鼠在复苏后1、4、6 h的血清白细胞介素-6（interleukin-6，IL-6）、IL-10、肿瘤坏死因子α（tumor necrosis factor-α，TNF-α）、肌酐（creatinine，SCr）、尿素氮（blood urea nitrogen，BUN）、胱抑素C（cystatin-C，CysC）水平。复苏6 h后将3组大鼠处死留取肾脏组织，观察其病理损伤变化。结果·3组大鼠基线资料的差异无统计学意义。心肺复苏后，L组和C组大鼠血清炎症因子和肾功能指标较S组同期指标明显升高（均Pα水平较C组降低（均P0.000），IL-10水平较C组升高（P0.000，P0.002，P0.036），差异均有统计学意义。复苏后1、4、6 h，L组肾功能指标SCr（P0.001，P0.007，P0.472）、BUN（P0.001，P0.004，P0.122）、CysC（P0.493，P0.001，P0.175）较C组升高；但L组SCr、BUN指标仅在复苏后1、4 h与C组之间的差异有统计学意义，CysC指标仅在复苏后4 h与C组之间的差异有统计学意义。L组和C组大鼠肾组织病理表现均提示发生明显急性肾损伤，L组病理损伤程度轻于C组（均P0.000）。结论·心搏骤停–心肺复苏后大鼠肾损伤明显，左西孟旦对其肾功能有明显保护作用。

关键词: 心室纤颤, 心搏骤停, 心肺复苏, 左西孟旦, 肾功能

Abstract:

Objective · To investigate the effects of levosimendan on kidney injury in the rat model of cardiopulmonary resuscitation. Methods · Twenty-five healthy adult male SD rats were randomly divided into three groups, which were sham group (S group, n5), levosimendan group (L group, n10) and control group (C group, n10). Cardiac arrest and cardiopulmonary resuscitation procedure were created in L group and C groupinducing ventricular fibrillation. L group was treated with levosimendan during and after resuscitation, while C group and S group were given equivalent volume of saline solution. S group was not induced into cardiac arrest and resuscitation. Serum interleukin-6 (IL-6), IL-10, tumor necrosis factor-α (TNF-α), creatinine (SCr), blood urea nitrogen (BUN) and cystatin-C (CysC) levels were compared between L group and C group at 1, 4 and 6 h after resuscitation.Three groups of rats were sacrificed, and the pathological changes of kidney tissues were observed at 6 h after resuscitation. Results · All rats were resuscitated successfully. No differences were found between the three groups about baseline data. After resuscitation, compared with S group, the levels of serum inflammatory cytokines and kidney function indicators increased dramatically (all PP0.000, P0.002, P0.036) than those in C group, and there were significant differences between the two groups (all P0.000). In resuscitation after 1, 4 and 6 h, the levels of SCr (P0.001, P0.007, P0.472), BUN (P0.001, P0.004, P0.122) and CysC (P0.493, P0.001, P0.175) were lower in L group than those in C group. Only 1 and 4 hours after resuscitation, the differences in the levels of SCr and BUN were significant, and only 4 hours after resuscitation, the difference in the level of CysC was significant between L group and C group. Both L and C group showed pathological characteristics of severe acute kidney injury, and the pathological injury scores of L group were alleviated compared with those of C group (all P0.000). Conclusion · Levosimendan can improve kidney injury of cardiac arrest and cardiopulmonary resuscitation model rats.

Key words: ventricular fibrillation, cardiac arrest (CA), cardiopulmonary resuscitation (CPR), levosimendan, kidney function