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目的探讨早期应用血必净对脓毒症导致急性肾损伤后肾小管细胞凋亡的影响,及凋亡相关蛋白Bcl-2和Bax表达的变化。方法 54只SD大鼠,♂,随机分为假手术组、脓毒症组、血必净组,每组18只;各组再分为3个亚组,每组6只。根据实验要求分别以术后12,24,48 h作为时间观察点,在各时间点检测大鼠的血液生化指标,测定肾脏血流、并留取肾脏组织观察病理学变化,测定肾小管损伤评分,采用原位末端标记法测定肾小管凋亡细胞,并计算积分光密度值(IOD)。采用免疫印迹法测定Bcl-2、Bax的变化。结果血必净组能明显改善肾功能,稳定血流动力学,减轻组织病理学变化,减少肾小管细胞凋亡,肾小管损伤评分和IOD值与脓毒症组相比有显著差异(P<0.01)。同时,血必净组能升高Bcl-2的表达,抑制Bax的表达,保持Bcl-2/Bax的平衡,与脓毒症组相比有显著差异(P<0.01)。结论早期应用血必净可以减少肾小管细胞在脓毒症进程中的凋亡,改善脓毒症导致急性肾损伤的病理学改变,保持Bcl-2/Bax的平衡,减轻脓毒症导致的肾损伤。
Objective To investigate the effects of early application of Xuebijing on apoptosis of renal tubular cells induced by acute renal injury induced by sepsis and the changes of apoptosis-related proteins Bcl-2 and Bax. Methods Fifty-four SD rats were randomly divided into sham operation group, sepsis group and Xuebijing group, with 18 rats in each group. Each group was divided into 3 subgroups, 6 rats in each group. According to the experimental requirements, respectively, after 12,24,48 h as a time point of observation, at each time point detection of blood biochemical indicators of rats, determination of renal blood flow, and the kidneys were removed to observe the pathological changes, determination of renal tubular injury score The apoptosis of renal tubular cells was measured by in situ end labeling and the integral optical density (IOD) value was calculated. Western blotting was used to detect the changes of Bcl-2 and Bax. Results Xuebijing group can significantly improve renal function, stabilize hemodynamics, reduce histopathological changes, reduce tubular cell apoptosis, tubule damage score and IOD value compared with sepsis group was significantly different (P < 0.01). Meanwhile, Xuebijing group could increase the expression of Bcl-2, inhibit the expression of Bax and maintain the balance of Bcl-2 / Bax, which was significantly different from that in sepsis group (P <0.01). Conclusions Early use of Xuebijing can reduce the apoptosis of tubular cells during sepsis, improve the pathological changes of acute kidney injury caused by sepsis, maintain the balance of Bcl-2 / Bax, and relieve the kidney damage caused by sepsis damage.