重度爆炸冲击伤所致肾功能损伤与肾小管上皮细胞铁死亡

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【中图分类号】R826.1；R827 【文献标志码】A

【Abstract】ObjectiveToinvestigaterenalimpairmentandferoptosisduetosevereblastijuriesandrelatedmechanism.Method： The goats were placed 3 meters away from the center of an 8 kg TNT-equivalent explosive to carry out blast injury experiments.The physicalparametersofblastwavesweremeasured，ndtepathologicalseverityoflastinjurieswasgrdedandsoredtossthe severityof injuries.Vitalsigns，blood gas parameters，andrenal function markers were measured before injuryandat 1，3，6，and24 （20 hours fterinjury.Renaltissesampleswerecoletedat24hoursafterinjurytopreparetissuesections，hichwereusedtopefo HE staining and measure the changes in the content of Fe2+ and the expression of the ferroptosis-related marker proteins xCT and GPX4 inrenaltisse，andPrussianbluestaining wasperformedforrenal issuesections toinvestigatethemechansmasoiatedwith renal impairmentandferroptosis of renal cels.Results ：Severe blast injuries acounted forthe highest proportionof 47.2% in experimental goats，while mild，moderate，severe，and extremely severe injuries accounted for 2.8%，36.1%，47.2%， and 13.9% ，respectively， and the pathologic severity score of blast injury was 2.56±0.15 .For the goats after blast injury，there were significant increases in heart rate（ F=12.750，P<0.01） and respiratory rate（ F=6.500，P<0.01 ）and significant reductions in anal temperature （ F=3.496，P< 0.05），partial pressure of blood oxygen（ F=24.630，P<0.01 ），and blood oxygen saturation（ F=18.560，P<0.01 ），as well assignificant increasesin the levels of blood uric acid（ F=22.320 ， P<0.01 ），serumcreatinine F=15.350，P<0.01） ，and blood urea nitrogen（ F= 22.310， P<0.01 ）.Comparedwith thecontrol group，swelling of renal tubular epithelial celsand narrowing of tubularlumen were observed at24 hoursafter blast injury，with a significant increase in the content of Fe2+ inrenal tissue（ t=5.933，P⋅ <0.01），significant reductions in the relative expression protein levels of GPX4（t=7.924，P<0.01） and xCT（t=4.483，P<0.01） in renal tissue，and depositionofalargeamountofironionsinenaltubularepithelialcels.Conclusion：Experimentalgoatsplaced3metersawayfromtecenter of an 8 kg TNT-equivalent explosive can cause severe blast injuries，resulting in the onset of hypoxia，renal impairment，and ferroptosis of renal tubular epithelial cells.

【Key words】blast injury; ferroptosis;renal impairment;renal tubularepithelial cells

近年来由于国际上军事冲突及民间爆炸事件的频发，爆炸伤的发生率呈增高趋势，对军民的生命健康造成重大威胁[1-4]。（剩余11222字）