新型组合型肝肾支持系统治疗西藏小型猪急性肾衰模型的实验研究

摘要

Objective To evaluate the novel hybrid liver and renal support system the safety and efficacy of the treatment of Tibet mini pig model of renal failure .Methods Five Tibet miniature pig bilateral renal artery ligation approached to construct the models of renal failure ,treatment group was treated with therapy (CRRT mode) of the novel hybrid liver and renal support system after modeling ,while the control group received no treatment .Drawning venous blood endotoxin ,biochemical tests and aerobic anae‐robic culture when in the treatment of 0 ,4 ,8 h;then we observed the changes of biochemical indicators in Tibet mini pigs before and after treatment ;we recorded machine pressure monitoring indicators every 2 hour during treatment .Results The model of renal failure of two experimental animals were successfully constructed .The general condition of treatment group was improved after treated by the novel hybrid liver and renal support system ,while the control groups continued to deteriorate .The experimental ani‐mals did not appear abnormal ECG during the experiment .Two groups of animals showed no statistics significant difference (P>0 .05) in the period of 0 h .In the remaining period ,heart rate and respiratory rate in treatment group was significantly reduced(P<0 .05) ,while oxygen saturation and mean arterial pressure were significantly increased compared to control group(P<0 .05) .There was no differences of biochemical indicators between two groups before modeling (P>0 .05);after modeling both groups biochemi‐cal indicators was significantly increased compared with baseline (P<0 .05);after treatment of the hybrid liver and renal support systems in the treatment group ,the biochemical parameters were significantly decreased compared with baseline ,the difference was statistically significant different(P<0 .05) ,while the control group did not change significantly .Blood endotoxin measured results were less than 0 .5 EU/mL ,arteriovenous end aerobic anaerobic culture showed no bacterial growth .Pathological examination showed significant swelling of the renal tubular epithelium and tubular necrosis .Conclusion The novel hybrid liver and renal sup‐port system for the treatment of Tibet mini‐pig model of renal failure is safe and effective ,and it can be further attempts for clinical trials .%目的：评估新型组合型肝肾支持系统治疗西藏小型猪肾衰模型的安全性及有效性。方法将5头西藏小型猪采用结扎双侧肾动脉的方法构建肾衰模型，造模后治疗组用新型组合型肝肾支持系统进行治疗（CRRT模式），对照组造模后不进行治疗，在治疗0、4、8h抽取静脉血进行内毒素、生化检测及需氧菌培养厌氧菌培养，观察造模前后、治疗前后西藏小型猪的各项生化指标的变化；实验过程中每2小时记录仪器的各项压力监测指标。结果两组实验动物肾衰模型均构建成功，治疗组经过新型组合型肝肾支持系统治疗后，一般情况改善；对照组动物一般情况持续恶化。实验动物在实验过程中，心电图未出现明显异常，两组动物在0 h时生命体征差异无统计学意义（P＞0．05），其余时段治疗组心率和呼吸频率明显低于对照组（P＜0．05），而血氧饱和度和平均动脉压明显高于对照组（P＜0．05）；造模前两组实验动物的生化指标差异无统计学意义（P＞0．05）；造模后两组动物与造模前相比差异有统计学意义（P＜0．05）；治疗组经肝肾支持系统治疗后，各项生化指标明显下降，与治疗前相比，差异有统计学意义（P＜0．05）；而对照组未出现明显变化。内毒素水平均低于0．5 EU／mL ，动静脉端需氧、厌氧菌培养结果显示未见细菌生长。病理检查见明显的肾小管上皮肿胀、肾小管坏死。结论新型组合型肝肾支持系统用于治疗西藏小型猪肾衰模型是安全、有效的，可进一步尝试用于临床试验。