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1、门静脉高压症大鼠阻断门静脉和下腔静脉后肾脏损伤的研究作者:吴凤东窦剑赵鑫任贵军邸恩昌【摘要】目的:探讨门静脉高压症大鼠阻断门静脉和下腔静脉1h后肾脏损伤的情况。方法:Wistar大鼠随机分为对照组、门脉高压症对照组和实验组。实验组先建立可复性门静脉高压症大鼠模型,3周后按阻断下腔静脉和肝门1h后不同的再灌注时间0h、6h、12h、24h、48h、72h和7d分为7组。于相应时间点查血清ALT、BIL、BUN、Cr水平,肾脏和肝脏组织光镜以及肾脏组织透射电镜检查。结果:实验组大鼠血BUN、Cr再灌注后6h开始升高,12~24h达高
2、峰,此后渐下降,72h已基本恢复正常。肾脏损害主要以近曲肾小管上皮细胞为主,12h、24h损伤达到高峰,可见核固缩、核碎裂,但基底膜保留完好。48h开始出现修复现象。7d后明显修复。结论:门静脉高压症大鼠阻断门静脉和下腔静脉后,肾小管上皮细胞有明显损伤,但是损伤是可逆的。【关键词】高血压门静脉・腔静脉,下・肾・大鼠,WistarThestudyofrenalinjuryinportalhypertensiverataftertheocclusionofportalvEinandinferiorvenacava【ABSTRACT】
3、Objective:ToinvestigatetherenalinjuryofportalhypertensiveratafteronehourofocclusionofportalvEInandinferiorvena:HealthymaleWistarratsweretakenrandomlyasnormalcontrol、portalhypertensivecontrolandtrialrecoverableportalhypertensivemodelwasinducedweekslater,1modelratswere
4、takenrandomlyasportalhypertensivecontrolgroup,othershadanotheroperationandweredividedrandomlyinto0,6h,12h,24h,48h,72h,7dgroupaccordingtodifferentreperfusiontimeafter1hourofocclusionofportalveinandinferiorvenathecorrespondingtimepointsafterreperfusion,theexaminationsb
5、elowweredone:serumALT,TBIL,BUN,Crconcentrations;morphologicalchangesofliverandkidney,theultrastructureofrenal:SerumBUNandCrintrailgroupreachedtheirpeakvalue12~2hoursafterreperfusion,thendecreasedgradually,andreturnedtonormalhoursaftermaininjuryofkidneywaslocatedinpro
6、ximaltubularepithelialcell,itpeakedat1hoursandhoursafterreperfusion,thesporadickaryopyknosisandkaryorrhexiscouldbeseen,butthebasementmembranepreservedlater,therestorationcouldbelateritrestored:Thereareobviousinjuryintubularepithelialcellintheportalhypertensiveratafte
7、r1hourofocclusionofportalveinandinferiorvenatheinjuryofkidneyisreversible.【KEYWORDS】Hypertension,portal・Venacava,inferior・Kidney・Rats,Wistar经典非转流肝移植病人,由于需暂时阻断下腔静脉,肾脏要经历缺血、淤血以及开放后再灌注的过程。本实验旨在通过研究门静脉高压症大鼠阻断门静脉和下腔静脉1h后肾脏损伤的情况,探讨该情况下肾脏损伤的特点及恢复规律,为临床提供参考。1材料与方法动物选择及分组健康雄性
8、Wistar大鼠,体重250~300g,共135只。随机分为对照组、门脉高压症对照组和实验组。实验组按阻断下腔静脉和肝门60min后不同的再灌注时间分为0h、6h、12h、24、48h、72h、7d7个组。全实验共9组,每组大鼠15只。可复性门静脉高压症大鼠模型