肢体远端缺血预处理对亲属肾移植术后肾功能的影响  

Effect of remote ischaemic preconditioning on renal function in patients undergoing living donor kidney transplantation

作　　者：郑华[1] 田玉科[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院麻醉科,武汉430030

出　　处：《临床外科杂志》2010年第8期572-574,共3页Journal of Clinical Surgery

基　　金：贝朗麻醉科学研究基金资助项目

摘　　要：目的 观察肢体远端缺血预处理对亲属肾移植术后肾功能的影响.方法 45例行亲属肾移植的患者随机分为实验组（23例）和对照组（22例）,实验组诱导插管后在上肢绑血压计袖带,充气压力200mm Hg持续5min,放气5min,做3个循环.对照组不作缺血预处理.记录患者手术后第1、2、3天24h尿量,检测术后24、48、72h血尿素氮,肌酐及尿酸.结果 实验组术后第1天尿量多于对照组（P〈0.05）,但24h血尿素氮、肌酐、尿酸差异无统计学意义.术后第2天两组尿量差异无统计学意义,但实验组48h血尿素氮、肌酐、尿酸低于对照组（P〈0.05）,实验组术后第3天尿量多于对照组（P〈0.05）,72h血尿素氮、肌酐、尿酸低于对照组（P〈0.05）. 结论肢体远端缺血预处理通过延迟性保护作用减轻缺血再灌注损伤,有利于亲属肾移植术后肾功能恢复.Objective The purpose of this study was to investigate effect of remote ischaemic preconditioning on renal function in patients undergoing living donor kidney transplantation. Methods Forty -five adult patients undergoing living donor kidney transplantation were randomly assigned to either a remote ischaemic preconditioning（RIP） group（ n = 23 ） or to a control group（ n = 22） after induction of anaesthesia. Remote ischaemic preconditioning consisted of three 5 - min cycles of upper limb ischaemia,induced by a cuffinflator placed on the upper arm and inflated to 200 mmHg, with an intervening 5 min of reperfusion during which the cuff was deflated. 24h urine volume, Blood urea nitrogen, serum creatinine and serum uric acid concentration was measured at 24,48 and 72 h after surgery. Resnits The RIPC group had significantly more urine volume in the first day after operation （ P 〈 0.05 ）. But all patients were similar in blood urea nitrogen, serum creatinine and serum uric acid at 24 h after surgery （ P 〉 0.05 ）. There was no significant difference of urine volume in the second day after operation（P 〉 0.05 ）. But concentration of blood urea nitrogen, serum creatinine and serum uric acid postoperatively were lower in the RIPC group compared with control patients at 48 h（ P 〈 0. 05 ）. In the third day the urine volume was more in RIPC group than control group（P 〈 0.05 ）. At 72 h after surgery the concentration of blood urea nitrogen,semm creatinine and serum uric acid were lower in the the RIPC group than control group （P 〈 0. 05）. Conclusion Remote ischaemic preconditioning can improve renal function through delayed protection against ischemia reperfusion injury in patients undergoing living donor kidney transplantation.

关 键 词：肢体远端缺血预处理 肾移植 

分 类 号：R692[医药卫生—泌尿科学]