目的:检测肾缺血/再灌注大鼠尿液胱抑素C含量,探讨其在缺血/再灌注急性肾损伤早期评估中的作用.方法:选取雄性SD大鼠,随机分为4组,建立缺血/再灌注急性肾损伤动物模型,缺血时间4组分别为0、10、20、30 min,测定各组大鼠术前及再灌注24 h后尿液胱抑素C,血清肌酐(Scr)、尿素氮(BUN)浓度,计算24 h肌酐清除率(Ccr),取各组再灌注24 h后肾组织作组织学检查,行肾小管坏死半定量评分.结果:各组大鼠基线肾功能差异无统计学意义,再灌注24 h后与基线值相比,肾缺血0 min组及10 min组BUN、Scr及Ccr无显著改变;肾缺血20 min组BUN、Scr无显著改变,但Ccr显著降低;肾缺血30 min组BUN[(45.3±14.6)vs(13.8±1.6)mmol/L]、Scr[(160.8±22.2)vs(36.9±7.9)μmol/L]显著升高,Ccr显著降低[(1.87±0.3)vs(0.56±0.1)ml/min].20 min组及30 min组肾小管坏死评分与0 rain组相比显著升高.再灌注24 h后与基线值相比,肾缺血0 min组尿液胱抑素C水平无显著改变,肾缺血10 min[(0.79±0.11)、vs(0.25±0.02)μg/L]、20 min[(1.23±0.35)vs,(0.30±0.05)μg/L]及30 min组[(1.33±0.51)vs(0.28±0.03)μg/L]尿液胱抑素C水平显著升高.结论:尿液胱抑素C测定可望成为缺血佴灌注急性肾损伤的早期诊断标记物.%Objective: To determine the urinary cystatin C in rats of ischemia/reperfusion(I/R) acute kidney injury,and to estimate their effects on early diagnosis. Methods: Male SD rats were selected and divided into 4 groups for I/R injury model estab-lishment. The time for bilateral renal artery occlusion were 0,10,20 and 30 rain respectively. The urine cystatin C,serum creatinine (Scr) and BUN of baseline and 24 h after reperfusion were detected.The kidney histological examination 24 h after reperfusion was performed. Results:The basline values of renal function in 4 groups were not different statistically. Compared with those at baseline,at 24 h after reperfusion, BUN, Scr and Ccr did not change significantly in ischernia 10 min group and BUN, Ser in 20 rain group. Ccr decreased significantly in 20min group. In 30 min group,BUN [(45.3±14.6) vs (13.8±1.6)mmol/L] ,Scr[(160.8±22.2) vs(36.9±7.9)panol/L] increased significantly,and Ccr decreased significantly [ ( 1.87±0.3) vs (0.56±0.1 )ml/min]. The urinary cystatin C levels were increased significantly in 10 rain group [(0.79±0.11 ) vs (0.25±0.02)μg/L] ,20 rain group [( 1.23 ±0.35) vs (0.30±0.05)μg/L] and 30 min group [ ( 1.33±0.51 ) vs (0.28±0.03)μg/L] compared with those at baseline. Conclu-sion:The determination of urinary cystatin C is usefuU for early diagnosis of I/R acute kidney injury.
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