| Objective: Acute renal ischemia-reperfusion is a common ischemic damage in clinical. Ischemia can cause renal blood flow reduction , corpuscle jams and tubular necrosis. And after the ensuing ischemia reperfusion can cause different degrees of kidney morphologic changes. In order to evaluate the protection of remifentanil on renal ischemia-reperfusion (I/R) injury, we studied the protective effect of remifentanil against renal ischemia-reperfusion injury with intravenous pumping before ischemia; Observing and analyzing the feasibility of the protective effect of remifentanil against renal ischemia-reperfusion injury. Our study will provide a basis for clinical application.Methods: Forty healthy male Wistar rats weighing 250±20g were divided into 4 groups randomly: Group A (Sham-Operation group): we just needed to anaesthetize these rats , open abdominal cavity and cut off the right renal, and pumping the physiological saline via the tail vein with constant speed in 30 minutes; Group B (Ischemia-Reperfusion group): we needed to anaesthetize these rats, open abdominal cavity, cut off the right renal , and pumping the physiological saline via the tail vein with constant speed from 30 minutes before ischemia ; Group C (Remifentanil of low dose): Pumping remifentanil via the rats vein with constant speed (0.5μg·kg-1min-1) from 30 minutes before ischemia ; Group D (Remifentanil of high dose): Pumping remifentanil via the rats vein with constant speed (1μg·kg-1min-1) from 30 minutes before ischemia . The rats of group A,B,C and D all cut off the right renal, in order to avoid the side of the compensatory function. The rats of group B, C and D using non-invasive artery clamp to clamp the left renal pedicle in order to blocking the blood supply of the renal and after 45 minutes take down the artery clamp. If the renal turn from modena to red explored the ischemia reperfusion model is successful. Closed the abdominal cavity of rats and put these in rat box continue raising after 24 hours'reperfusion. Then anaesthetize these rats again. And collect blood sample 2ml from the chamber of the heart to determine BUN and CREA. Meanwhile, we took out the renal of the rats and selected the upper pole of the left kidney to make into crumb about 1×1×1mm using sharp knife to prepare for using the electron microscope camera to observe renal ultra structure, and then cut two small refrigerator freezers for the production of organizational dissolution to detect SOD and MDA content, fixed the remainder of the renal by 10% formalin and make into paraffin-embedded sections, observed the sample under light microscope camera after HE staining.SPSS13.0 statistical software was applied to conduct statistical analysis. Data were expressed as means±std. Comparisons between groups were made by using one-way ANOVA and comparisons in group were made by using repeated measure ANOVA. If the difference between the contrast group was a significant statistical one, express the statistical significance using P< 0.05 .Results:1 The results of renal function:The concentrations of serum BUN and Cr in group A is significantly higher than other three groups after 24 hours'reperfusion ,there is significant difference (P<0.05), The concentrations of serum BUN and Cr in group C and group D is significantly higher than group A, there is significant difference (P<0.05); The concentrations of serum BUN and Cr in group C is significantly higher than group D, there is significant difference (P<0.05).2 SOD content in renal tissue:The SOD content in group A was higher than other groups, there is a significant difference (P<0.05); And SOD content in group C and D was higher than group B, there is a significant difference (P<0.05); At the same time SOD content in group D was higher than group C, there is a significant difference (P<0.05).3 MDA content in renal tissue: The MDA content in group A was significantly lower than other groups, there is a significant difference (P<0.05); And MDA content in group C and D was lower than group B, there is a significant difference (P<0.05); At the same time MDA content in group D was lower than group C, there is a significant difference (P<0.05).4 The result of light microscope:In the blank control group, The stuctural of renal is integrated, kidney tubules aligned, without edema and inflammatory cells infiltrating; The group of renal ischemia-reperfusion was observed renal interstitial hyperemia, renal tubular epithelial cells cloudy swelling and degeneration necerosis; The pathological changes of group C and D are lighter than group B, We can see a part of renal tubular with mild swelling and renal tubular epithelial cells has mild edema.5 The result of transmission electron microscope:In the blank control group there are mainly has normal cells that nuclear morphology regularity. In the group B we can see that renal tubular epithelial endoplasmic relicula, microvilli discorder, mitochondria markedly swollen, cristae inside gap expansion etc. The pathological changes of group C and D are lighter than group B, we can see individual chromatin crumb and single renal tubular epithelial mild edema.Conclusion:1 Remifentanil preconditioning plays a role in protection against renal ischemia-reperfusion injury.2 The effect of protection of remifentanil preconditioning is induced partly relevant to oxidative damage.3 The effect of remifentanil on reducing infarct size was dose dependent.
|
PDF Full Text Request