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目的观察重症急性胰腺炎(severe acute pancreatitis,SAP)大鼠肾损伤的血清及尿液生化指标变化趋势。方法选取健康雄性Sprague-Dawley大鼠240只,按照随机数字表随机均分为8组各30只,即SAP不同时间点组(SAP 1h、3h、6h、9h、12h、18h、24h组)和对照组。比较各组大鼠血清淀粉酶(amylase,AMY)、血肌酐(serum creatinine,SCr)、血尿素氮(blood urea nitrogen,BUN)、血尿酸(uric acid,UA)以及尿液中肌酐(urine creatinine,UCr)浓度、肾损伤分子(kidney injury molecule,KIM)-1以及β-N-乙酰氨基葡萄糖苷酶(β-N-acetyl amino glycosidase enzymes,NAG)含量的变化。结果 SAP 1h、3h、6h、9h、12h、18h和24h组SCr、BUN、UA浓度、KIM-1含量和NAG相对浓度均高于对照组,UCr浓度均低于对照组,差异有统计学意义(P<0.05)。结论 SAP肾损伤中,肾小管的损伤早于肾小球的损伤。KIM-1和NAG作为判定肾小管损伤的指标,敏感度和特异度均优于Cr、BUN和UA,且能早期诊断SAP时肾损伤。
Objective To observe the changes of serum and urine biochemical indexes in renal injury of rats with severe acute pancreatitis (SAP). Methods A total of 240 healthy male Sprague-Dawley rats were randomly divided into 8 groups (n = 30) according to a random number table: SAP at different time points (SAP 1h, 3h, 6h, 9h, 12h, 18h, 24h) Control group. Serum amylase (AMY), serum creatinine (SCr), blood urea nitrogen (BUN), uric acid (UA) and urine creatinine , UCr), the level of KIM-1 and N-acetylglucosaminidase (NAG) in kidney of rats were measured. Results The relative concentrations of SCr, BUN, UA, KIM-1 and NAG in SAP groups at 1h, 3h, 6h, 9h, 12h, 18h and 24h were significantly higher than those in control group and UCr concentrations were lower than those in control group (P <0.05). Conclusion In the renal injury of SAP, the damage of renal tubules is earlier than that of glomeruli. KIM-1 and NAG as indicators of renal tubular damage, sensitivity and specificity are better than Cr, BUN and UA, and early diagnosis of renal injury in SAP.