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目的研究心肺复苏后大鼠肾小管上皮细胞的凋亡情况及其可能机制。方法Sprague Dawley雄性大鼠48只,随机分为6组:对照组(假手术组)以及复苏后3、6、12、24、48h组,每组各8只。采用窒息合并冰氯化钾(0·5mol/L)停跳液致大鼠心搏骤停-心肺复苏模型,心搏骤停5min后开始心肺复苏。采用TUNEL法观察复苏后肾小管上皮细胞的凋亡情况,采用免疫组化的方法观察大鼠肾小管上皮细胞Bcl-2、Fas蛋白的表达情况。结果复苏后3h大鼠肾小管上皮细胞就有明显凋亡,之后表达持续增加,至24h达高峰,平均灰度值为(19·75±4·04)%。复苏后3h肾小管上皮细胞Bcl-2有少量表达,其后表达呈上升趋势,48h达到高峰。而Fas复苏后3h呈高表达,与对照组比较(P<0·01),平均灰度值为(47·78±2·18)%,随后持续高表达,至24h达高峰。结论心肺复苏后大鼠存在肾小管上皮细胞凋亡,其中Fas的高表达介导了肾小管上皮细胞凋亡。
Objective To study the apoptosis of rat renal tubular epithelial cells after cardiopulmonary resuscitation and its possible mechanism. Methods Forty-eight Sprague Dawley male rats were randomly divided into 6 groups: control group (sham operation group) and 3,6,12,24,48h group after resuscitation, 8 rats in each group. Cardiac arrest - CPR model was induced by asphyxiation combined with potassium chloride (0 · 5 mol / L) cardioplegia in cardioplegia. Cardiopulmonary resuscitation was started 5 minutes after cardiac arrest. TUNEL method was used to observe the apoptosis of renal tubular epithelial cells after resuscitation. The expression of Bcl-2 and Fas protein in renal tubular epithelial cells was observed by immunohistochemical method. Results After 3 hours of resuscitation, rat renal tubular epithelial cells showed obvious apoptosis, and then the expression continued to increase. After reaching the peak at 24 h, the mean gray value was (19 · 75 ± 4.40)%. The expression of Bcl-2 in renal tubular epithelial cells was slightly increased 3 h after resuscitation, and the expression of Bcl-2 increased gradually after 48 h. However, the expression of Fas was high at 3 h after resuscitation. Compared with the control group (P <0.01), the average gray value was (47.78 ± 2.18)%. Conclusions There is apoptosis of renal tubular epithelial cells in rats after cardiopulmonary resuscitation, in which the high expression of Fas mediates the apoptosis of renal tubular epithelial cells.