【摘要】：【目的】觀察右美托咪定（Dexmedetomidine，DEX）對(duì)膿毒癥大鼠急性腎損傷（AKI）的保護(hù)作用及對(duì)腎組織高遷移率族蛋白1（HMGBl）mRNA表達(dá)及血清胱抑素C（Cys C）水平的影響，探討DEX對(duì)膿毒癥大鼠AKI保護(hù)作用的相關(guān)機(jī)制，為其應(yīng)用于膿毒癥臨床治療提供理論基礎(chǔ)。 【方法】48只健康成年雄性SD大鼠，體重240-270g，采用隨機(jī)數(shù)表法分為3組（n=16）：假手術(shù)組（SHAM組）、模型組（CLP組）、右美托咪定組（DEX組）。CLP組和DEX組采用盲腸結(jié)扎與穿孔術(shù)（CLP）制備大鼠膿毒癥誘發(fā)AKI模型。術(shù)后1h，DEX組腹腔內(nèi)注射DEX40μg/kg，SHAM組和CLP組給予等容量生理鹽水。各組分別于術(shù)后24h、48h時(shí)取血后隨機(jī)處死8只大鼠，留取雙側(cè)腎臟。分別應(yīng)用免疫比濁法檢測(cè)血清Cys C水平，實(shí)時(shí)熒光定量PCR法檢測(cè)腎組織HMGB1mRNA表達(dá)水平，，光學(xué)顯微鏡觀察腎組織病理學(xué)損傷情況。 【結(jié)果】與SHAM組同時(shí)間點(diǎn)比較，CLP組和DEX組術(shù)后24h、48h腎組織HMGB1mRNA表達(dá)明顯上調(diào)，血清Cys C水平顯著升高（P0.05），腎組織均有不同程度的病理學(xué)損傷；與CLP組同時(shí)間點(diǎn)比較，DEX組術(shù)后24h、48h腎組織HMGB1mRNA表達(dá)下調(diào)，血清Cys C水平降低（P0.05），腎組織病理學(xué)損傷減輕。 【結(jié)論】DEX能有效減輕膿毒癥大鼠腎組織病理?yè)p傷，降低血清Cys C、腎組織HMGB1mRNA表達(dá)水平，對(duì)膿毒癥急性腎損傷具有一定保護(hù)作用，其機(jī)制可能與DEX抑制腎組織HMGB1mRNA的表達(dá)有關(guān)。
[Abstract]:[objective] to observe the protective effect of right metomidate (Dexmedetomidine,DEX) on (AKI) and the expression of high mobility group protein 1 (HMGBl) mRNA in renal tissue and the level of serum cystatin C (Cys C) in rats with acute renal injury induced by sepsis. To explore the protective mechanism of DEX on AKI in septic rats, and to provide a theoretical basis for its application in the clinical treatment of sepsis. [methods] 48 healthy adult male SD rats weighing 240? 270 g were randomly divided into 3 groups (n = 16): sham operation group (SHAM group) and model group (CLP group). The model of sepsis induced by AKI in DEX group (). CLP group) and DEX group (DEX group) was induced by cecal ligation and puncture with (CLP). One hour after operation, DEX 40 渭 g / kg,SHAM and CLP were injected intraperitoneally into the DEX group. At 24 h and 48 h after operation, 8 rats in each group were killed at random and bilateral kidneys were retained. Serum Cys-C level was measured by immunoturbidimetric method, HMGB1mRNA expression was detected by real-time fluorescence quantitative PCR, and pathological damage of renal tissue was observed by optical microscope. [results] compared with SHAM group, the expression of HMGB1mRNA and serum Cys-C were up-regulated and serum Cys-C level was significantly increased in CLP group and DEX group 24 h after operation (P0.05), and there were different degrees of pathological injury in renal tissue. Compared with CLP group, the expression of HMGB1mRNA in renal tissue and serum Cys C level were decreased in DEX group at 24 h and 48 h after operation (P0.05), and the renal histopathological injury was alleviated. [conclusion] DEX can effectively reduce the pathological injury of renal tissue, decrease the expression level of serum Cys-C and HMGB1mRNA in renal tissue of sepsis rats, and has a protective effect on acute renal injury of sepsis. The mechanism may be related to the inhibition of HMGB1mRNA expression in renal tissue by DEX.
【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R459.7;R614

【參考文獻(xiàn)】

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1 董劍;;血清胱抑素C測(cè)定的臨床意義[J];實(shí)驗(yàn)與檢驗(yàn)醫(yī)學(xué);2011年01期

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