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目的研究星状神经节阻滞(SGB)对横纹肌溶解引起的大鼠急性肾功能衰竭(ARF)是否有保护作用并探讨其机制。方法健康成年SD大鼠36只,随机分为3组:假手术组(Sham组)、急性肾衰组(ARF组)、急性肾衰+颈交感干离断组(ARF+TCST组)。每组大鼠于处理后24 h和48 h各取一半,观察24 h尿量、全自动生化仪检测血肌酐(Scr)和尿素氮(BUN)的水平,HE染色观察肾脏组织形态学变化,免疫组化法测定肾脏细胞凋亡促进蛋白Bax的表达。结果术后24 h和48 h,ARF组和ARF+TCST组大鼠比Sham组尿量均显著减少,血浆Scr和BUN明显增高,差异有统计学意义(P<0.01),肾小管细胞破坏严重,Bax表达明显增强,差异有统计学意义(P<0.01);与ARF组相比,ARF+TCST组尿量增加,血浆Scr和BUN水平下降,差异有统计学意义(P<0.01),肾组织结构损伤减轻,Bax表达减弱,差异有统计学意义(P<0.01)。结论 SGB可以减轻横纹肌溶解导致的急性肾损伤。
Objective To investigate whether stellate ganglion block (SGB) has a protective effect on rhabdomyolysis-induced acute renal failure (ARF) and to explore its mechanism. Methods Thirty - six healthy adult Sprague Dawley rats were randomly divided into 3 groups: Sham group, acute renal failure group (ARF group), acute renal failure + cervical sympathetic dry off group (ARF + TCST group). The rats in each group were sacrificed 24 h and 48 h after treatment, the urinary output was observed for 24 h, the levels of serum creatinine (Scr) and blood urea nitrogen (BUN) were measured by automatic biochemical analyzer, the morphological changes of kidney were observed by HE staining, Immunohistochemical method was used to detect the expression of apoptosis promoting protein Bax in kidney. Results At 24 h and 48 h after operation, the urine volume of rats in ARF group and ARF + TCST group was significantly lower than that in Sham group, and the levels of Scr and BUN in plasma were significantly increased (P <0.01) (P <0.01). Compared with the ARF group, the urinary volume increased and the levels of Scr and BUN in the ARF + TCST group decreased significantly (P <0.01), and the difference was statistically significant The damage of tissue structure was alleviated and the expression of Bax was weakened. The difference was statistically significant (P <0.01). Conclusion SGB can alleviate acute renal injury caused by rhabdomyolysis.