摘要
目的探讨水通道蛋白2（AQP2）在脓毒症大鼠肾脏的表达及对水代谢调节的意义。方法将6周龄Wistar大鼠64只，随机分为假手术组和手术组各32只，采用盲肠结扎穿孔法（CLP）复制脓毒症模型。每组分为3、6、12和24h4个亚组，各8只，分别留取尿液、血液、肾脏标本。观察尿量、尿渗透压和肾功能，HE染色光镜观察肾脏病理变化，采用实时定量PCR方法检测AQP2mRNA表达，免疫组织化学方法检测AQP2的蛋白表达。结果手术组大鼠术后3h尿量减少、尿渗透压增高，6h后尿量逐渐增多、尿渗透压降低；血肌酐和尿素6h开始升高，24h达高峰；随术后时间延长肾脏病理损害加重，主要表现为肾小管上皮细胞之间间隔消失，细胞核消失；肾小球球襻融合，细胞结构不清；间质可见点灶状炎性细胞侵润。AQP2mRNA的表达在术后3h增高，12、24h明显减低；AQP2蛋白表达在术后12h下降，24h最低，较假手术组均有显著性差异（P〈0．05）。结论AQP2参与脓毒症时肾脏水代谢的调节，AQP2表达下调是导致脓毒症尿浓缩功能障碍的主要病理机制之一。
Objective To investigate the expression and the significance of AQP2 in the kidneys of septic rats. Methods Sixty-four Wistar rats of 6 weeks were randomly divided into two groups： sham group and the septic model group. Septic models were made by cecum ligation perforation （CLP）. Each group was divided into 3-hour,6-hour,12-hour and 24-hour subgroups,with 8 rats in each. The urine,blood and kidney sampies were collected. The urine volume, urine osmotic pressure and renal function were observed. The expressions of AQP2 protein in rats＇ kidneys were determined by using immunohistochernical method and the expressions of AQP2 mRNA with real-time PCR. The pathological changes of the kidneys were observed under light microscopy. Results After CLP,urea volume of Wistar rats in septic model group decreased and urine osmotic pressure increased at 3 hours;urea volume gradually increased and urine osmotic pressure decreased at 6 hours; Serum Cr and urea nitrogen began to increase at 6 hours and reached the peak at 24 hours. The longer the time lasted after CLP,the more serious the injury of kidney became ,which was mainly manifested as that the space between the epithelial cells of the tubular wall disappeared, nucleus disappeared, glomerular loops fused, and cell structure was unclear. Renal mesenchymal was infiltrated with inflammatory ceils. AQP2 mRNA expression increased at 3 hours, decreased at 12 hours and 24 hours, AQP2 protein expression decreased at 12 hours, with the lowest at 24 hours, which were significantly different from those of the sham groups（P 〈 0. 05）. Conclusion AQP2 may regulate the water metabolism of septic rats＇ kidney. The decreased AQP2 protein expression is one of the main pathological mechanisms that results in dysfunction of urine concentration in sepsis.
出处
《中国小儿急救医学》
CAS
2009年第4期365-368,I0002,共5页
Chinese Pediatric Emergency Medicine
