在肾肿块减少2/3的实验模型中气腹在肾小球滤过中的作用

Marco Aurélio Valadão, D. Fagundes, Willian Cesar Cavazana, Gabriel Jorge Fagundes
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摘要

目的:探讨co2气腹对肾实质减少2/3大鼠肾小球滤过的影响。方法:50只成年Wistar雄性大鼠行右肾切除术,左肾血管支2/3结扎。动物随机分布如下:GI组(n = 10) -模拟,GII组(n = 20) - 8 mm Hg气腹,GIII组(n = 20) - 15 mm Hg气腹。在灌气2小时(GIIA和GIIIA)、3小时(GIIB和GIIIB)和去气1小时后,对他们进行以下方面的评估:平均血压(MBP)、微血细胞比容、尿量和菊粉清除率。结果:显微镜检查显示肾小球硬化引起蛋白尿。8 mm Hg气腹停气2小时(Δ% = 202.68)后肾功能优于3小时(Δ% = 10.89)。15 mm Hg气腹组,2小时(Δ% = -3.57)和3小时(Δ% = -3.25)均对肾功能造成损害。结论:菊粉清除率在肾体积减少2/3的模型中表现为肾功能不全,且随着暴露时间的增加和压力强度的增加,其程度可进一步增强。
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The role of pneumoperitoneum in the glomerular filtration in an experimental model with 2/3 reduction of the renal mass
Objective: To evaluate the influence of the CO 2 pneumoperitoneum in the glomerular filtration in a rat model with a 2/3 reduction of renal parenchyma. Methods: Adult Wistar male rats (n = 50) were subjected to right nephrectomy and a 2/3 ligature of the renal left vascular branch. Animals were randomly distributed as follows: GI (n = 10) - simulated, GII (n = 20) –8 mm Hg pneumoperitoneum, and GIII (n = 20) –15 mm Hg pneumoperitoneum. After two (GIIA and GIIIA) and three (GIIB and GIIIB) hours of insufflation, and one hour of disinsufflation, they were evaluated for the following aspects: mean blood pressure (MBP), microhematocrit, urinary volume and inulin clearance. Results: The microscopic aspects showed signs of glomerulosclerosis that caused proteinuria. Renal function with8 mm Hg pneumoperitoneum after two hours of disinsufflation (Δ% = 202.68) was better than after three hours (Δ% = 10.89). With15 mm Hg pneumoperitoneum, the renal function was damaged by both procedures, that is, two (Δ% = -3.57) and three hours (Δ% = -3.25). Conclusion: Inulin clearance evidenced renal insufficiency in the model with a 2/3 reduction of renal mass, and depending on both the increase of the exposure time and the pressure intensity, it can be more intensified.
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