中文摘要：

目的观察肾脏急性缺血再灌注损伤（ischemic reperfusion，I／R）后大鼠肾脏及血清中肿瘤坏死因子α（tumor necrosis factor-α，TNF-α）、肾损伤分子1（kidney injury molecule-1，Kim-1）的表达变化。方法选取雄性SD大鼠96只，体质量250-300g，随机分为假手术组（Sham组，n=48），缺血再灌注组（I／R组，n=48），通过夹闭双肾动脉建立大鼠肾脏缺血再灌注模型，各组于术后2h、6h、12h、24h、48h、72h每时点随机选取8只大鼠，分别取血及肾皮质标本。全自动生化分析仪检测血清肌酐、尿素氮，酶联免疫吸附试验（enzyme linked immunosorbent assay，ELISA）检测血清TNF-α、Kim-1水平，免疫组织化学检测肾组织TNF-α、Kim-1表达。结果与Sham组血清肌酐、尿素氮水平[（50．8±6．8）μmol／L、（4．7±0．5）mmol／L]比较，I／R组均于I／R损伤后6h开始升高[血清肌酐I／R6h时为（79．6±8．8）μmol／L、尿素氮I／R6h时为（9．3±1．6）mmol／L，均P〈0．053。ELISA检测结果显示，与Sham组血清TNF-α（843．0±60．5）、Kim-1（453．7±56．4）水平比较，I／R组均于I／R2h开始升高[I／R2h时血清TNF-α为（944．2±68．3）、Kim-1为（1081．3±126．2），均P〈0．053，48h达高峰，但TNF-α于72h明显下降（3094．4±230．5），血清Kim-1水平48-72h保持高值。免疫组织化学检测显示I／R损伤后TNF-α、Kim-1主要表达于肾小管，且均在12h表达最多。结论血清TNF-α与Kim-1能较早提示急性肾脏损伤，但Kim-1优于TNF-α。

英文摘要：

Objective To observe the expression of tumor necrosis factor alpha （TNF-α）, and kidney injury molecule-1 （Kim-1） in the kidney tissues and serum of rats subjected to acute renal ischemic repel-fusion injury. Methods Ninety-six SD male rats were randomly divided into Sham group （n = 48） and ischemic/reperfusion group （I/R, n = 48）. The bilateral arteries were blocked to make the IR models. Eight rats from the two groups were randomly selected 2, 6, 12, 24, 48 and 72 h after the surgery, and the blood and renal cortex collected. Serum nitrogen and creatinine were evaluated by biochemical autoanalyzer. The concentrations of TNF-α and Kim-1 were measured by ELISA. The TNF-α and Kim-1 expression in kidney tissues was detected by immunohistochemistry. Results As compared with Sham group, the BUN and SCr began to increase in I/R group at 6 h after I-R （for BUN, 50. 8 ± 6. 8 vs. 79. 6 ± 8. 8 μmol/L, and for SCr, （4. 7 ± 0. 5） vs. （9. 3 ± 1.6） mmol/L, P〈 0. 05 for both）. ELISA revealed that the serum TNF-α and Kim-1 were increased at 2 h after I/R in I/ R group as compared with Sham group （for TNF-α, 944. 2 ± 68. 3 vs. 843.0 ± 60. 5; for Kim-1, 1081.3 ± 126. 2 vs. 453. 7 ± 56. 4, P〈0. 05 for both）, which reached a peak at 48 h after reperfusion, but TNF-α was decreased obviously after 72 h （3 094. 4 ± 230. 5）, and Kim-1 was kept the highest level from 48 to 72 h. Immunohistochemistry showed that TNF-α and Kim-1 were mainly expressed on the tubular area and increased significantly at 12 h after I/R. Conclusions Serum TNF-α and Kim-1 might be appropriate biological markers of acute kidney injury, and Kim-1 might be better.