Protective Effect And Mechanism Of Cyclic Adenosine Phosphate On Kidney In Patients With Extensive Burn

Objective To study the protective effect and mechanism of cyclic adenosine monophosphate（c AMP）on renal function after extensive burns through clinical monitoring and assisting animal models.Methods This study is divided into two parts.The first part is the study on the renal protection of cyclic adenosine monophosphate in the treatment of patients with extensive burns.From December 2018 to December 2020,all patients with a burn area of≥30%and above were selected.130 burn patients were taken as the research objects and were randomly divided into group A and group B.Group A received conventional treatment combined with normal saline treatment,and group B was treated with c AMP on the basis of group A.The renal function of the two groups of patients at different time periods was compared.Indicator changes.The second part is the study of the mechanism of cyclic adenosine monophosphate on the protection of renal function in extensively burned rats.74 healthy male SD rats from the same batch were selected and randomly divided into three groups（group D,E,F）,group D As a normal rat control group,no special treatment is required.Groups E and F were treated with burns.Group E was injected with normal saline intraperitoneally,and group F was injected with c AMP drug intraperitoneally.Hematoxylin-eosin（HE）staining and real-time fluorescent quantitative PCR（RT-q PCR method）and TUNEL method to detect changes in rat kidney tissue structure and changes in renal function indicators.Result Part 1:1.Creatinine（Cr）changes:There was no significant difference in Cr index between the two groups of patients at T₀ time（p>0.05）,and the Cr value of the two groups of patients in the T0 to T4 period gradually decreased with the change of time point（p<0.05）),and the Cr of the two groups of patients during the T₁ to T₄period was significantly lower than the T₀ time（p<0.05）,and the Cr value of group B in this time period was significantly lower than that of group A（p<0.05）;2.Cystatin C（Cys C）changes:There was no significant difference in the Cys C index between the two groups of patients at T₀ time（p>0.05）,and the Cys C value of the two groups of patients in the T₀ to T₄ time period gradually decreased with the change of time（p<0.05）),and the Cys C of the two groups of patients during the T1 to T4 period was significantly lower than the T₀ time（p<0.05）,and the Cys C value of group B in this time period was significantly lower than that of group A（p<0.05）;3.Changes in urea nitrogen（BUN）:There was no significant difference in the BUN index of the two groups of patients at T₀ time（p>0.05）,and the BUN of the two groups of patients in the T0 to T4 time period gradually decreased with the change of time point（p<0.05）,and the BUN of the two groups of patients during the T1 to T4 period was significantly lower than the T₀ time（p<0.05）,and the BUN value of group B in this time period was significantly lower than that of group A（p<0.05）;4.Urine kidney injury molecule-1（KIM-1）changes:There was no significant difference in the KIM-1 index between the two groups of patients at T₀ time（p>0.05）,and the KIM-1 value of the two groups of patients in the T0 to T4 time period increased with The time point changes gradually decreased（p<0.05）,and the KIM-1 of the two groups of patients at the time T1 to T4Significantly lower than T₀time（p<0.05）,and the KIM-1 value of group B in this time period was significantly lower than that of group A（p<0.05）;5.Treatment time:There was no significant difference in the operation time between the two groups of patients（p>0.05）,but the anesthesia recovery time and hospital stay of the patients in group B were significantly lower than those in group A（p<0.05）;Part 2:1.Renal tubular injury score:The renal tubular injury scores of rats in group E and F were higher than those in group D（p<0.05）,but the scores of rats in group F the renal tubular damage score was significantly lower than that of the E group（p<0.05）;2.Wnt-1、Wnt-4 andβ-catenin expression:the protein relative expression of Wnt-1、Wnt-4 andβ-catenin in both group E and group F were significantly higher than those in group D（p<0.05）,but the protein relative expression of Wnt-1、Wnt-4 andβ-catenin in group F was significantly lower than that in group E（p<0.05）3.Renal function indexes:all renal function indexes of group E rats it was significantly higher than that of group D and group F（p<0.05）,but there was no significant difference between group D and group F（p>0.05）.Conclusion Cyclic adenosine monophosphate coud be effectively used in the anesthesia for patients with extensive burns,can effectively reduce the renal function damage of the patients,shorten the patient’s anesthesia recovery time and hospital stay,and reduce the economic burden of the patients,and its mechanism of action is By inhibiting the expression of Wnt-1,Wnt-4 andβ-catenin in kidney tissues,it can improve kidney function and exert a protective effect on the kidneys.