肢体缺血预处理对兔肾急性缺血再灌注损伤的保护作用  

Protective effect of limb ischemic preconditioning on rabbit kidney following acute ischemia/reperfusion injur

作　　者：方针强[1] 叶钢[1] 刘永亮[1] 贾维胜[1] 肖亚[1] 

机构地区：[1]第三军医大学新桥医院泌尿外科全军肾脏病中心,重庆400037

出　　处：《重庆医学》2008年第7期743-745,共3页Chongqing medicine

摘　　要：目的观察肢体缺血预处理对肾脏急性缺血再灌注损伤(IRI)能否产生保护作用,并通过肾功能、组织病理学等检测评估其效果。方法(1)建模:40只新西兰大白兔随机分为3个组,假手术(S)组8只,缺血再灌注(IR)组和预处理(LIP)组各16只,后2个组兔采用右肾切除、左肾动静脉阻断1h开放法建立肾脏缺血再灌注模型,S组仅切除右肾,游离左肾动静脉但不阻断。(2)肢体缺血预处理方法:LIP组在阻断前,先以止血带在双下肢根部绑扎,阻断血流5min,完全开放10min,反复4次。(3)评估指标:对比各组兔在再灌注后8、24h和3、7d时肾功能、肾组织MDA含量和SOD活性以及组织病理学差异。结果LIP组再灌注后血清Scr和BUN升高幅度要明显低于IR组(P<0.05),在再灌注后3d内血Scr和BUN明显低于IR组(P<0.05);LIP组再灌注后24h内SOD活性和MDA含量的变化幅度明显低于IR组(P<0.05),且在各时间点SOD活性均明显高于IR组(P<0.05),MDA含量均明显低于IR组(P<0.05);LIP组光镜下病理改变轻于IR组。结论肢体缺血预处理能减轻肾脏缺血再灌注引起的组织病理改变,降低肾组织MDA含量并增加SOD活性,改善肾功能,对急性肾脏IRI起到明显的保护作用。Objective To observe the protective effect of the limb ischemic preconditioning on kidney following acute ischemia/ reperfusion injury,and assess its efficacy by renal function and histopathological detection. Methods （1）Modeling： Forty New Zealand rabbits were randomly divided into sham-operated group（S,n=8） ,ischemia/reperfusion group（IR,n 16） ,limb ischemic preconditioning group（LIP,n = 16）. The acute ischemia/reperfusion models of kidney were established in the latter two groups by excising the right kidney and occluding the left renal artery and vein for 1 hour,while S group was only subjected to right nephrectomy and liberation of left renal artery and vein without occlusion of its bloodstream. （2） Method of LIP： Before occusion, both lower limbs of the rabbits in the LIP group were occluded with tourniquet for 5 minutes following by 10 minutes reperfusion for 4 times. （3）Evaluation： The renal function, MDA contents and SOD activity in kidney, and histopathology among the three groups were compared after 8 and 24 hours,3 and 7 days reperfusion. Results The heightening extent of Scr and BUN of LIP group after reperfusion was significantly lower than those of IR group（P〈0.05）. The Scr and BUN of LIP group within 3 days reperfusion were significantly lower than those of IR group（P〈0.05）. The changed extent of SOD activity and MDA contents of LIP group after 24 hours reperfusion were significantly lower than those of IR group（P〈0.05）. The SOD activity of LIP group at each time point was significantly higher than that of IR group（P〈0.05） ,and the MDA contents of LIP group significantly lower than that of IR group （P〈0.05）. The histopathologic changes of kidney of LIP group were significantly slighter than those of IR group. Conclusion Limb ischemic preconditioning could obviously prevent the histopathological changes caused by renal ischemia/reperfusion injury, cut down the MDA contents,increase the SOD activity and improve the renal function, which sho

关 键 词：肾脏 肢体缺血预处理 缺血再灌注损伤 

分 类 号：R692[医药卫生—泌尿科学]