摘要
为了阐明内毒素介导急性肾功能衰竭的机理,观察了内毒素性肾功能衰竭家兔血液凝固性变化和肾脏的病理形态学变化。与对照组家兔比较,模型组家兔血小板计数和血浆纤维蛋白原含量极显著降低(P<0 01),出血时间、凝血时间、凝血酶原时间和白陶土部分凝血活酶生成时间显著或极显著延长(P<0 05,P<0 01)。另一方面,内毒素注射在全部模型组家兔导致了弥漫性血管内凝血,71.4%的肾小球中发现了微血栓,肾小球纤维素密度指数达60 6%。此外,96.2%的肾小管上皮细胞变性坏死,84.1%的肾小管中有管型形成。对照组家兔均未发现这些病理变化。上述试验结果揭示,内毒素引发了弥漫性血管内凝血,而肾小球毛细血管内广泛形成的微血栓阻断了肾小球毛细血管血流,从而导致肾小球滤过率降低,这是内毒素介导急性肾功能衰竭的首要机理。此外,肾小管上皮细胞的变性、坏死可损害其重吸收和分泌功能,管型形成可阻塞肾小管管腔并增大肾球囊内的压力,这些也都是在内毒素介导急性肾功能衰竭发生发展过程中起重要作用的因素。
In order to clarify the pathogenesis of endotoxin-induced acute renal failure, the blood coagulation changes and the pathomorphologic changes of kidney were investigated while the renal function was being measured in the rabbits given intravenous injections of E.coli O_(111)B_4 endotoxin. The platelet count and content of plasma fibrinogen were significantly reduced (P<0.01), and bleeding, clotting, prothrombin time and kaolin partial thromboplastin time were markedly prolonged (P<0.05, P<0.01) as compared with the saline-injected control rabbits. On the other hand, the intravenous injections of endotoxin triggered disseminated intravascular coagulation (DIC) in all the rabbits given endotoxin, microthrombi were found in 71.4 percent of the glomeruli, and the mean index of fibrin concentration per glomerulus was 60.6 percent. In addition, the degeneration and necrosis of epithelial cells and the formation of tube cast were found in 96.2 and 84.1 percent of renal tubules, respectively. However, none of the control rabbits showed similar pathologic changes. These results suggested that the coagulation changes induced by endotoxin triggered glomerular capillary thrombosis, the blood flow in the capillaries was blocked , thus the glomerular filtration rate was reduced. This may be the chief mechanism of endotoxin-induced acute renal failure. Additionally, the degeneration and necrosis of the epithelial cells of the renal tubules may impair their reAbsorption and secretion capability, and the formation of tube cast block the lumen of the renal tubule and increase the pressure in Bowman’s capsule. These may also be responsible for the pathogenesis of endotoxemic acute renal failure.
出处
《畜牧兽医学报》
CAS
CSCD
北大核心
2005年第3期283-287,共5页
ACTA VETERINARIA ET ZOOTECHNICA SINICA
基金
贵州省自然科学基金资助项目[黔基合计字(2001)3035号]
