【摘要】目的 构建生物人工肾小管装置(RAD），观察其对急性肾衰竭并多器官功能障碍综合征(ARF-MODS)猪炎症过程的影响。方法 采用猪肾近曲小管细胞，以滤器AV-400S作支撑，构建RAD。用双肾肾动脉钳闭法加盲肠结扎、穿孔法制作ARF-MODS猪模型，随机分为连续性血液滤过（CVVH）治疗组（n=6）和CVVH+RAD治疗组(n=6)，观察其生存时间，并分别于治疗开始时、治疗12h和治疗24h等时点取血标本检测血清IL-6、TNF-α、IL-10浓度。结果 ①抽样检测RAD，其菊粉复原率为(0.965±0.027)，显微镜下显示肾小管上皮细胞基本覆盖了空心纤维内壁； ② CVVH+RAD组与CVVH组生存时间分别为(36.82±10.78)小时，(28.46±9.82)h，前者明显长于后者(P＜0.05）； ③ CVVH+RAD组与CVVH组治疗24h时血清IL-10浓度较同组治疗前升高(P＜0.05），其上升幅度前者显著高于后者(P＜0.05）；二组治疗24h时血清IL-6、TNF-α浓度较同组治疗前均有下降(P＜0.05），但二组间比较无显著差异。结论 CVVH+RAD治疗ARF-MODS疗效优于单纯CVVH治疗；CVVH+RAD可提升抗炎因子IL-10水平，改善致炎椏寡滓蜃蛹涞钠胶猓饪赡苁荝AD治疗ARF-MODS的机制之一。

【Abstract】 Object To construct bioartificial renal tubule assist device (RAD) and to investigate the effect of this device on inflammation processes in pigs suffering from multiple organ dysfunction syndrome and acute renal failure (ARF-MODS). Method The bioartificial renal tubule assist device was fabricated using porcine renal proximal tubule cells growing in an AV-400S hemofilter. ARF-MODS pigs (n=20) were induced by incarceration of bilateral renal arteries, ligation and perforation of cecum. The animals were then randomly divided into two groups: continuous venovenous hemofiltration (CVVH) treated group (n=6) and CVVH+RAD treated group (n=6). Their survival time was calculated. Serum IL-6, TNF-α and IL-10 were measured by ELISA at 0, 12 and 24 hours after treatment. Results (a) The inulin recuperative rate of RAD was 0.965±0.027 by spot check. Microscopy revealed that the cells cover the inner surface of the hollow fibers almost completely. (b) The average survival time in CVVH+RAD treated group was 36.82±10.78 hours, longer than that in CVVH treated group (28.46±9.82 hours, P＜0.05). (c) In the CVVH+RAD and CVVH groups, serum IL-10 was higher at 24 hours after treatment than at 0 hour (P＜0.05), especially in the former group at 24 hours after the treatment (P＜0.05). Serum IL-6 and TNF-α decreased in the 2 groups after treatment for 24 hours (P＜0.05), but the changes of the 2 cytokines had no statistical differences between the 2 groups. Conclusion CVVH+RAD treatment was superior to CVVH treatment for ARF-MODS pigs. RAD treatment increased the serum anti-inflammatory factor IL-10, and maintained the balance between inflammatory factors and anti-inflammatory factors, which may be the mechanisms to be effective in ARF-MODS pigs.