高压氧治疗对高能冲击波致肾损伤治疗作用的实验研究

发布时间：2018-05-27 14:04

本文选题：高压氧治疗 + 高能冲击波　；参考：《广西医科大学》2014年硕士论文

【摘要】：目的：通过高压氧疗（Hyperbaric oxygen therapeutics，HBOT）对高能冲击波（High energy shock wave，HESW）致肾损伤的兔动物模型进行干预，探讨HBOT对HESW引起的肾损伤的治疗效果及其可能的机制。方法：30只健康雄性新西兰大白兔，随机分空白对照组（n=10）、模型对照组（n=10）、治疗组（n=10）。模型对照组及治疗组在B超引导下按12KV的电压、60次/分钟的频率冲击兔左肾中部2000次，建立HESW致肾损伤模型。治疗组于建模后24h开始接受连续7天、每天1次HBOT。模型对照组建模后不予HBOT干预；空白对照组仅行备皮、麻醉，不予HESW或HBOT干预。于试验前、冲击后4h及HBOT后的24h、72h、7d的对应时期经耳中动脉采血，检测血清SCR、BUN、ET-1、TNF-α、MDA、SOD。分别在试验的4h、24h、72h采血后于各组随机抽取一只白兔全麻下摘取双肾、在试验7d采血后全麻下摘取所有白兔的双肾，作HE染色组织病理检查。结果：1．动物模型：成功建立新西兰大白兔HESW肾损伤模型； 2．白兔体重：三组白兔组间比较均无差异（P＞0.05）；空白对照组试验7d的体重大于试验前（P＜0.05）; 3．血清学检测结果：（1）SCR和BUN：三组白兔各时期组内及组间比较均无差异（P＞0.05）; （2）ET-1、TNF-α及MDA：三组结果试验前均无差异（P＞0.05）；模型对照组和治疗组在4h、24h、72h的结果均高于空白对照组（P＜0.05），7d时则三组结果相仿（P＞0.05）；治疗组24h、72h的结果均低于同时期模型对照组（P＜0.05）；组内比较显示，模型对照组和治疗组的各检测值在冲击后呈上升趋势（P＜0.05），7d时基本恢复到试验前水平（P＞0.05）；（3）SOD：三组试验前无差异（P＞0.05）；模型对照组和治疗组4h、24h、72h的结果均低于空白对照组（P＜0.05），7d时三组结果相仿（P＞0.05）；治疗组24h、72h的结果均高于同时期模型对照组（P＜0.05）；组内比较显示，模型对照组和治疗组的SOD在冲击后呈下降趋势（P＜0.05），7d时基本恢复到试验前水平（P＞0.05）； 4．HE染色组织病理检查：空白对照组肾组织病理检查未见异常；模型对照组及治疗组肾脏均有不同程度肾小球肾小管结构破坏和间质充血出血、水肿、炎细胞浸润、纤维化等改变，，而治疗组的损伤程度轻于模型对照组；接受HESW处理白兔的右肾亦可见程度轻于左肾的肾间质充血、细胞水肿、炎症细胞浸润等变化。结论：1．高压氧治疗可通过减少自由基的生成、减轻脂质过氧化、抑制过量炎症因子及血管活性物质的释放等等多种作用机制，对高能冲击波引起的肾脏损伤有着多方面的保护作用； 2. HESW冲击正常兔的一侧肾脏，其对侧肾脏亦存在一定程度的损伤性改变，不宜选用自体肾脏作对照研究。
[Abstract]:Objective: to investigate the effect and possible mechanism of hyperbaric oxygen therapy (HBOT) on renal injury induced by high energy shock wave (HESW) in rabbits, and to explore the therapeutic effect of HBOT on renal injury induced by HESW. Methods 30 healthy male New Zealand white rabbits were randomly divided into control group (n = 10), model control group (n = 10) and treatment group (n = 10). The model control group and the treatment group were subjected to 60 times of 12KV voltage per minute and 2000 times to the middle of the left kidney under the guidance of B-ultrasound to establish the model of renal injury induced by HESW. The treatment group received HBOT once a day for 7 days at 24 h after modeling. The model control group did not intervene with HBOT after modeling, while the blank control group only received skin preparation, anesthesia and no HESW or HBOT intervention. The blood samples were collected from the middle ear artery before the experiment, 4 hours after shock and 24 hours after HBOT. The blood samples were collected from the middle ear artery to detect the serum SCRN BUNET-1 TNF- 伪 and MDA-SOD. Two kidneys were randomly selected from one white rabbit under general anesthesia after blood collection at 4 h and 24 h for 72 h in each group. After 7 days of blood collection, the two kidneys of all white rabbits were removed under general anesthesia for HE staining histopathological examination. The result is 1: 1. Animal model: HESW renal injury model was successfully established in New Zealand white rabbits. 2. The weight of white rabbits: there was no difference among the three groups (P > 0.05), the weight of the blank control group was higher than that of the control group on the 7th day (P < 0.05). 3. Serological results: There was no significant difference in SCR and bun among the three groups (P > 0.05). The results of TNF- 伪 and MDAin the model control group and the treatment group were higher than that of the blank control group at 24 h and 72 h, respectively, and the results of the treatment group were lower than those of the model control group at 24 h and 72 h respectively (P < 0.05), and the results of the treatment group at 24 h were lower than those of the control group at 24 h (P < 0.05), the results of the treatment group were lower than that of the control group at 24 h after the treatment (P < 0.05), and the results of the treatment group were higher than those of the control group (P < 0.05). The detection values of the model control group and the treatment group showed an upward trend after shock (P < 0.05) and returned to the pre-test level after 7 days (P > 0.05). The results of the model control group and the treatment group were lower than that of the blank control group (P < 0.05) and the results of the treatment group were higher than that of the model control group (P < 0.05) at 24 h or 72 h, the results of the treatment group were higher than that of the model control group (P < 0.05), and the results of the treatment group were higher than those of the control group (P < 0.05), and the results of the three groups were similar to those of the control group (P < 0.05) at 7d after the treatment, the results of the treatment group were higher than those of the model control group (P < 0.05). The SOD of the model control group and the treatment group showed a downward trend after shock (P < 0.05) and returned to the pre-test level after 7 days (P > 0.05). 4.HE staining histopathological examination: there was no abnormal renal histopathological examination in blank control group, glomerular tubular structure destruction and interstitial hyperemia hemorrhage, edema, inflammatory cell infiltration were found in model control group and treatment group. The degree of injury in the treatment group was less than that in the model control group, and the degree of interstitial congestion, cell edema and inflammatory cell infiltration in the right kidney treated with HESW was less than that in the left kidney. Conclusion 1. Hyperbaric oxygen therapy can reduce the production of free radicals, reduce lipid peroxidation, inhibit the release of excessive inflammatory factors and vasoactive substances, and have many protective effects on renal injury induced by high energy shock wave. 2. The contralateral kidney of HESW was damaged to some extent, so it was not suitable to choose autogenous kidney as a control study.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R692.5

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