[Effects of different fluid resuscitation on renal function and glycocalyx in septic shock rats]

Zhonghua Nei Ke Za Zhi. 2021 Jun 1;60(6):552-555. doi: 10.3760/cma.j.cn112138-20200628-00626.
[Article in Chinese]

Abstract

To investigate the effects of different fluid resuscitation on renal function and glycocalyx in septic shock rats. The septic shock SD rats (induced by lipopolysaccharide) were randomly divided into control group, normal saline resuscitation group, Lactate Ringer's solution resuscitation group and succinyl gelatin resuscitation group (n=6 each). The mean arterial pressure, heart rate, serum creatinine (Scr), urea nitrogen (BUN), renal blood flow, renal tissue pathology, serum interleukin-6, tumor necrosis factor α and glycocalyx were measured at baseline, the development of septic shock, 0 hour and 8 hours after resuscitation. When shock was established, the renal blood flow significantly decreased (P<0.05) and recovered to normal at 0 hour and 8 hours after resuscitation. Compared with normal saline group and succinyl gelatin group, the levels of Scr, BUN and glycocalyx components (heparan sulfate, syndecan-1) were significant lower in Lactate Ringer's solution group (P<0.05). The pathology of kidney tissue suggested that the microscopic ischemic damage with Lactate Ringer's solution were minor than the other two groups. Compared with normal saline and succinyl gelatin, Lactate Ringer's solution can reduce the damage of renal function and glycocalyx in septic shock rats.

探讨不同液体复苏对脓毒性休克大鼠肾功能及糖萼的影响。按随机数字法将大鼠分成健康对照组、生理盐水复苏组、乳酸林格液复苏组和琥珀酰明胶复苏组,每组6只。制作脓毒性休克大鼠模型,根据不同的液体进行复苏,监测4组大鼠复苏前后不同时间点的平均动脉压、心率、血肌酐、尿素氮、肾脏血流评分、白细胞介素-6、肿瘤坏死因子α、糖萼水平、肾组织病理变化、复苏过程中复苏时间及所用去甲肾上腺素量。在休克复苏过程中,3个复苏组大鼠所用去甲肾上腺素剂量差异无统计学意义(P>0.05),琥珀酰明胶复苏组复苏时间最短,与其他2个复苏组比差异有统计学意义(P<0.05)。休克后,3个复苏组大鼠肾脏血流明显降低,血肌酐、尿素氮、白细胞介素-6、肿瘤坏死因子α水平均明显升高(P<0.05)。复苏后,3个复苏组大鼠肾脏血流恢复至正常,乳酸林格液复苏组血肌酐、尿素氮水平恢复正常,乳酸林格液复苏组糖萼成分低于其他2个复苏组(P<0.05)。肾组织病理可见,经过液体复苏后出现肾小管水肿,管腔变小,少许炎性细胞浸润,未见明显坏死,但乳酸林格液复苏组肾脏病变较其他2个复苏组轻。乳酸林格液可减少脓毒性休克大鼠肾功能和糖萼损伤。.

MeSH terms

  • Animals
  • Fluid Therapy
  • Glycocalyx
  • Rats
  • Rats, Sprague-Dawley
  • Shock, Hemorrhagic* / drug therapy
  • Shock, Septic* / therapy