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.DOCVIP

临床医学论文-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，Wistar ?????? The study of renal injury in portal hypertensive rat after the occlusion of portal vein and inferior vena cava ?????? 【ABSTRACT】Objective:To investigate the renal injury of portal hypertensive rat after one hour of occlusion of portal vein and inferior vena cava.Methods:Healthy male Wistar rats were taken randomly as normal control、portal hypertensive control and trial group.The recoverable portal hypertensive model was induced firstly.Three weeks later ,15 model rats were taken randomly as portal hypertensive control group,others had another operation and were divided randomly into 0,6h,12h,24h,48h,72h,7d group according to different reperfusion time after 1 hour of occlusion of portal vein and inferior vena cava.At the corresponding time points after reperfusion,the examinations below were done:serum ALT,TBIL,BUN,Cr concentrations;morphological changes of liver and kidney,the ultrastructure of renal tissue.Results:Serum BUNand Cr in trail group reached their peak value 12~24 hours after reperfusion,then decreased gradually,and returned to normal 72 hours after reperfusion.The main injury of kidney was located in proximal tubular epithelial cell ,it peaked at 12 hours and 24 hours after reperfusion,the sporadic karyopyknosis and karyorrhexis could be seen,but the basement membrane preserved well.48 hours later,the restoration could be seen.7 days later it restored obviously.Conclusion:There are obvious injury in tubular epithelial cell in the portal hypertensive rat after 1 hour of occlusion of portal vein