| Objective:The study was human-induced rat model of severe acute pancreatitis through animal experiment.We analyzed the changes of pathophysiology with kidney injury of severe acute pancreatitis without any pretreatments for studying the degrees of kidney injury during the evolution process.That is to provide a new theory basement for the clinical diagnosis and therapy.Methods:Two hundred and forty Sprague-Dawley male rats of body weight 250-300g were divided randomly into eight groups with thirty rats in each group:severe acute pancreatitis group(SAP) with two hundred and ten rats in different times and sham operation group(SO) with thirty rats.Severe acute pancreatitis animal model was induced by injection of 3.5%sodium deoxycholate through retrogradely common biliopancreatic ducts.Rats in SO only flipped intestine gently.The rates of mortality of rats were obtained at 1,3,6,9,12,18 and 24 hours respectively in SAP and 1 hour in SO after the operation.General and histological changes of pancreas and kidney were evaluated by the corresponding scores.At the same time,The contents of PH,sodium ion,kalium ion,and serum amylase(AMY) were detected by blood gas analysis.Meanwhile,the contents of serum creatinine(SCr),blood urea nitrogen(BUN),serum uric acid(UA),urine creatinine(UCr) were detected by automatic biochemical analyzer in different hours.The content of kidney injury molecule(KIM)-1 was detected by ELISA,and the content ofβ-N-acetyglocosamidase(NAG) was detected by colorimetric determination.Results:The rates of mortality of rats:SO group,1h group,3h group,6h group,9h group,12h group,18h group,24h group were as follows:0%,0%,0%,6.7%,20%,40%,70%,90%. The differences of mortality among SO group,1h group,and 3h group had no statistical significance(P＞0.05).The general and histological changes of pancreas and kidney:General appearance,pancreas frozen sticky partially like bleeding in 3h,pancreas and surrounding tissue were adhered and there can be seen saponification in 9h,the pancreas was vague and there was a bit of bloody ascites in abdomen in 12h,the contour of pancreatic was disappear and intestinal paralysis was occurred in 24h.There were no significant differences among groups with kidney tissue. Histological appearance,the severity of the lesions was aggravated going with the process of pancreas and renal injury.The scores of kidney injury:SO group:3.33±3.20,1h group:6.00±3.57.The differences among SO and 1h group; 18h and 24h group had no statistical significance,howerer, the scores were increased.Blood gas analysis:PH,SO group:7.36±0.04,1h group: 7.25±0.05.The differences among 1h and 3h group;3h and 6h group;6h and 9h group;9h and 12h group;12h and 18h group had no statistical significance,however,the values were decreased.The concentrations of Sodium ion(units: mmol/L),SO group:141.63±2.20,1h group:138.75±1.67. The differences among 1h and 3h group;3h and 6h group;6h and 9h group;9h,12h,18h and 24h group had no statistical significance,however,the concentrations were decreased. The concentrations of kalium ion,(units:mmol/L),SO group:3.34±0.29,1h group:3.66±0.28.The differences among 9h,12h,18h and 24h group had no statistical significance,however,the concentrations were increased.The concentrations of serum amylase(units:U/L):SO group:596.90±248.13,1h Group:1437.90±331.97.The difference between 9h and 12h group had no statistical significance,however,the concentrations were increased.The concentrations of serum creatinine(unit:μmol/L), blood urea nitrogen(units:mmol/L),serum uric acid(units:μmol/L) and urine creatinine(unit:mmol/L):SCr,SO group: 50.31±9.75,lh group:54.80±9.38.The differences among SO,1h and 3h group;6h,9h and 24h group had no statistical significance,however,at the time of 18h the contents reached the peak,and later,went down.BUN,SO group: 7.03±4.01,1h group:8.95±3.37.The differences among SO and 1h group;1h and 3h group;9h and 24h group had no statistical significance,however,at the time of 18h the contents reached the peak,and later,went down.UA,SO group:92.23±28.98,1h group:104.40±31.86.The differences among SO,1h and 3h group;6h and 24h group; 9h and 24h group had no statistical significance,however,at the time of 18h the contents reached the peak,and later,went down.UCr,SO group:2.01±0.33,1h group:1.91±0.34. The differences among SO,1h and 3h group;6h and 9h group had no statistical significance,however,the contents were decreased.The contents of kidney injury molecule(KIM)-1 (unit:pg/ml):SO group:20.60±19.07,1h group:62.22±31.12.The differences among 1h and 3h group;3h and 6h group;6h and 9h group had no statistical significance, however,the contents were increased.The contents ofβ-N-acetyglocosamidase(NAG)(unit: U/mmol):SO group:17.18±9.13,1h group:18.66±8.95. The difference between SO group and 1h group had no statistical significance,however,the contents were increased. Conclusions:1 The degree of kidney injury ralates to the process of severe acute pancreatitis.2 9 hour is a turning point for alleviating the degree of injury.3 Renal tubular injury is earlier than glomerular injury, and the function injury is earlier than the mobid histologic injury.Renal tubular injury runs through the whole process of renal injury.4 KIM or NAG,as an indicator of renal tubular injury determination,can be carried out in early diagnosis for its better issensitivity and specificity.5 The concentrations of Cr,BUN,UA have significant meaning in kidney injury.6 Azotemia,acidosis,dilutional hyponatremia and hyperkalemia relate to kidney injury of severe acute pancreatitis.
|
PDF Full Text Request