目的：探讨雌激素对失血性休克孕兔肾功能的影响。方法将40只妊娠新西兰白兔随机分为4组，正常对照组（NG），麻醉后不做放血及复苏处理；雌激素对照组（E2G），实验60 min静脉注射雌激素，余同NG组；雌激素休克组（E2SG）、果糖休克组（FSG），两组均在实验0~15 min做放血处理，孕兔达休克血压40 mmHg后维持45 min，然后分别静脉注射雌激素及果糖，观察20 min后予以复苏。对比各组不同时间点血清尿素氮、肌酐浓度变化，观察孕兔肾脏病理结果。结果 NG组和E2G组血清尿素氮及肌酐水平在实验过程中无明显变化；失血性休克后，FSG组及E2SG组血清尿素氮水平均在实验80 min始持续升高，FSG组血清尿素氮水平明显高于E2SG组（P<0.05）；FSG组及E2SG组血清肌酐水平在实验开始持续升高，60 min始持续下降，E2SG组下降速率快于FSG组（P<0.05）。结论雌激素能有效降低失血性休克孕兔血清尿素氮、肌酐水平，减轻肾脏病理损害，对失血性休克孕兔的肾功能有一定的保护作用。%Objective To evaluate the effects of estrogen on renal function of pregnant rabbits with hemorrhagic shock. Methods Forty pregnant New Zealand white rabbits were randomized into 4 groups, namely normal control group (NG group, with anesthesia only), estrogen group (E2 group, with additional estrogen injection at 60 min), estrogen-hemorrhagic shock (E2SG) group and fructose-hemorrhagic shock (FSG) group. In the latter two groups, the rabbits were subjected to phlebotomy for 15 min to induce hemorrhagic shock with a blood pressure of 40 mmHg; after maintenance of the pressure for 45 min, intravenous injections of estrogen or fructose were given before resuscitation 20 min later. Blood urea nitrogen (BUN) and creatinine (Cr) concentration were measured at different time points and renal pathology of the rabbits was observed. Results No significant differences were founding serum BUN and Cr levels between NG and E2G groups during the experiment. In FSG and E2SG groups, serum BUN level began to increase at 80 min after hemorrhagic shock and was significantly higher in FSG group (P<0.05);serum Cr level increased progressively from the start of the experiment and began to decrease at 60 min, with a faster rate of reduction in E2SG group (P<0.05). Conclusion Estrogen can effectively lower serum BUN and Cr levels and ameliorate renal pathologies to offer protective effect in pregnant rabbits against hemorrhagic shock.
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