缺血预处理对兔脊髓缺血再灌注损伤的延迟保护作用  

Delayed protective effects of ischemic preconditioning against spinal cord ischemical reperfusion injury in rabbits

作　　者：徐浩[1] 杨惠林[1] 唐天驷[1] 董天华[1] 

机构地区：[1]苏州大学附属第一人民医院骨科,江苏省苏州市215006

出　　处：《中国临床康复》2004年第29期6361-6363,i004,共4页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:脊髓缺血再灌注损伤机制复杂,各种单一药物保护作用有限。为此探讨缺血预处理(ischemicpreconditioning,IPC)对兔脊髓缺血再灌注损伤的延迟保护作用。方法:将大白兔随机分为3组。缺血组和IPC组各30只,采用肾下腹主动脉阻断法,建立脊髓缺血再灌注模型;假手术组10只,手术开始步骤同其他两组,但不做肾下腹主动脉阻断即缝合伤口。IPC组先阻断腹主动脉5min,开放10min,重复3次,48h后阻断腹主动脉35min后开放灌注,缺血组阻断腹主动脉35min后开放灌注。于术后4,8,24,48h,7d分别进行神经功能评分,观察脊髓标本的病理学改变,细胞凋亡情况及脊髓组织中白细胞介素()的水平测定。8IL-8结果:各时间点假手术组所有动物神经功能正常。缺血再灌注8,24,48h,7d神经功能Jacobs评分,缺血组分别为(1.90±1.65),(1.34±1.76),(0.71±0.75),(0.61±0.57)分,IPC组分别为3.50±1.46),((3.80±1.60),(3.77±1.75),(3.50±1.29)分,两组比较差异有非常显著性意义(t=3.98～11.12,P<0.01)。IPC组组织病理学变化各时间点明显好于缺血组,凋亡细胞数明显低于同时间点缺血组。再灌注8,24,48hIL-8水平,缺血组分别为(5877.32±530.406015.49±441.55),),((5050.49±271.22pg/g,IPC组为()5086.34±284.16,5215.61±411.66,)()(4385.AIM:The mechanism of spinal cord ischemical reperfusion injury is complicated.The protective effects of all kinds of single drugs are limited.So,the aim of this paper is to make an exploratory discussion on the delayed protective effects of ischemic preconditioning(IPC) on the spinal cord ischemical reperfusion injury in rabbits. METHODS:The white rabbits were randomly divided into three groups:ischemia group and IPC group with 30 in each group. The spinal cord ischemical reperfusion model was established by clamping the infrarenal abdominal aortic occlusion.Ten rabbits in sham operation group,the original process was the same as the other two groups,but the wound was sewed up immediately without doing infrarenal abdominal aortic occlusion.The abdominal aortic occlusion was performed in the IPC group for 5 minutes and reperfusion for 10 minutes.The process was repeated for three times.The abdominal aortic was occluded after 48 hours and then undertook reperfusion after 35 minutes.In the ischemia group,the abdominal aortic was occluded for 35 minutes and then undertook reperfusion.The neurological function was scored after ischemical reperfusion for 4,8,24,48 hours and 7 days respectively.The spinal cord pathologic changes,apoptosis and level assay of interleukin 8(IL 8) in the tissue of spinal cord were observed. RESULTS:The neurological function of the animals was normal in the sham operation group at every time points.The Jacobs scores of neurological function at 4,8,24,48 hours and 7 days in the ischemic group were(1.90±1.65),(1.34±1.76),(0.71±0.75),and(0.61±0.57) points.Scores of IPC group were(3.50±1.46),(3.80±1.60),(3.77±1.75),and(3.50±1.29) points.There was a very significantly difference between the two groups(t=3.98 to 11.12, P< 0.01).The histopathologic change in the IPC group at each time point were obviously better than that in the ischemic group.The number of apoptotic cells was significantly lower at the same time point than that in ischemic group. The IL 8 levels of the ischemic grou

关 键 词：脊髓缺血再灌注损伤 延迟保护作用 腹主动脉 缺血预处理 IPC 阻断 手术 开放 时间点 结论 

分 类 号：R651.2[医药卫生—外科学] R743[医药卫生—临床医学]