出 处:《中国医师杂志》2012年第5期589-592,共4页Journal of Chinese Physician
摘 要:目的观察异氟醚预处理对大鼠肾缺血再灌注(ischemia-reperfusion,I/R)损伤的影响,并探讨肿瘤坏死因子-α(TNF-α)在其中的作用。方法健康成年雄性SD大鼠36只,随机分成假手术组(s组),缺血再灌注组(I/R组)和异氟醚预处理组(Iso+I/R组),每组各12只。S组进腹后仅分离韧带不阻断血流;I/R,组行肾脏缺血45rain,再灌注2h;Iso+I/R组吸人1.5%(1MAC)异氟醚30min,停止吸入10rain后行I/R。在再灌注2h后测定血清尿素氮(BUN)和肌酐(cr)的含量,采用双抗体夹心酶联免疫吸附试验(ELISA法)测定。肾组织中TNF-α的浓度,同时取肾组织进行HE染色观察病理学改变。结果(1)与S组比较,I/R组和Iso+I/R组血清BUN和cr表达水平、肾组织中TNF-α浓度均升高[BUN:(17.69±0.99)mmol/LV8(8.37±1.12)mmol/L,t=-23.55,P〈0.01;(12.26±1.11)mmol/Lvs(8.37±1.12)mmol/L,t=-19.09,P〈0.01;Cr:(103.22±13.42)μmol/Lvs(71.48±8.59)μmol/L,t=-21.45,P〈0.01;(86.51±11.49)μmol/Lvs(71.48±8.59)μmol/L,t=-9.87,P〈0.01;TNF-α:(0.51±0.07)rig/mlvs(0.43±0.00)ng/ml,t=-5.79,P〈0.01;(0.47±0.03)ng/Ⅱdvs(0.43±0.00)ng/ml,t=-8.86,P〈0.01]。(2)Iso+I/R组血清BUN和Cr表达水平、肾组织中TNF-α浓度的升高幅度均小于I/R组[BUN:(12.26±1.11)mmol/LVS(17.69±0.99)retool/L,t=15.67,P〈0.01;Cr:(86.51±11.49)μmol/Lvs(103.22±13.42)μmol/L,t=6.68,P〈0.01;TNF-α:(0.47±0.03)ng/mlvs(0.51±0.07)ng/ml,t=2.61,P〈0.05]。(3)I/1t组、Iso+I/R组。肾小管评分较S组升高[(17.26±1.45)VS(0.00±0.00),t=-72.38,P〈0.01;(12.69±1.83)VS(0.00±0.00),t=-39.53,P〈0.01]。Iso+I/lt组肾小Objective To investigate the effects of isoflurane preconditioning on renal ischemia reperfusion (L/R) injury in rats and the role of TNF-α plays in the mechanism. Methods Male SD rats were used in the study. The animals were randomly divided into 3 groups ( n = 12 each) :shame operation group; L/R group; Isoflurane preconditioning group (inhaled 1.5% isoflurane (1 MAC) for 30 min followed by 10 min washout before L/R). At 2 h reperfusion, blood samples were obtained for urea nitrogen (BUN) concentration and creatinine (Cr) content. The level of TNF-α in renal tissues were determined by enzyme-linked immunosorbent assay (ELISA). Observe the pathological changes in H.E. staining slides under microscope. Results BUN concentration and Cr content and the level of TNF-α in L/R group and isoflurane preconditioning group were significantly higher than in shame operation group [ BUN : ( 17.69 ± 0. 99)mmol/L vs (8.37 ±1.12)mmol/L, t = -23.55, P 〈0.01;(12. 26 ± 1. 11)mmol/L vs (8. 37 ± 1.12) mmol/L, t = - 19. 09, P 〈 0. 01 ;Cr: ( 103.22 ± 13.42) μmoL//L vs (71.48 ± 8.59) μmoL/L, t = - 21.45, P 〈0.01;(86.51 ± 11.49) μmoL//L vs (71.48 ±8.59) μmoL/L, t = -9.87, P 〈0.01;TNF-α(0.51 ±0.07)ng/ml vs (0.43 ±0. 00)ng/ml, t = -5.79, P 〈0.01;(0.47 ±0.03)ng/ml vs (0.43 ± 0. 00) ng/ml, t = - 8. 86, P 〈 0. 01 ]. BUN concentration and Cr content and the level of TNF-α in Isoflurane preconditioning group were significantly lower than in I/R group [ BUN : ( 12. 26 ± 1.11 ) mmol/L vs ( 17.69 ± 0. 99) mmol/L, t = 15.67, P 〈 O. 01 ;Cr: (86. 51 ± 11.49) μmol/L vs ( 103.22 ± 13.42) μmol/ L, t =6. 68, P 〈0. 01 ;TNF-α (0. 47 ±0. 03) ng./ml vs (0. 51 ±0. 07) ng/ml, t =2. 61, P 〈0. 05]. The renal I/R injury which located around kidney tubules was increased in I/R group and isoflurane preconditioning group compared to shame operation group, ( 17.26 ± 1.45) vs (0. 00 ± 0. 00), t = - 72.
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