乳化异氟醚预处理对大鼠肾缺血再灌注损伤的影响  

Effect of emulsified isoflurane preconditioning on renal ischemia-reperfusion injury in rats

作　　者：覃兆军[1,2] 王焱林[1] 吕恩[2] 占乐云[2] 邢翔飞 张婧婧[1] 

机构地区：[1]武汉大学中南医院麻醉科,430071 [2]湖北省宜昌市第一人民医院麻醉科 [3]院长办公室

出　　处：《中华麻醉学杂志》2013年第4期496-498,共3页Chinese Journal of Anesthesiology

基　　金：湖北省卫生厅科研一般项目（JX5845）

摘　　要：目的评价乳化异氟醚预处理对大鼠肾缺血再灌注损伤的影响。方法选择雄性SD大鼠32只，体重220～300g，10～13周龄，采用随机数字表法，将其分为4组（n=8）：假手术组（s组）、肾缺血再灌注组（I／R组）、乳化异氟醚预处理组（E组）和脂肪乳剂预处理组（I组）。I／R组、E组和I组采用夹闭左侧肾蒂45rain后恢复再灌注的方法建立肾缺血再灌注模型。E组和I组分别静脉输注8％乳化异氟醚、30％脂肪乳剂4ml·kg-1·h-1 30min，洗脱15min后制备模型。于再灌注3h时采集腹主动脉血样5ml，测定血清肌酐（Cr）、胱抑素C（CysC）、TNF-α、IL-6、IL-10浓度；取左肾组织，行HE染色，光镜下观察病理学结果，并行肾脏近曲小管坏死程度分级。结果与s组比较，其余3组血清Cr、CysC、TNF-α、IL-6、IL-10浓度及肾脏近曲小管坏死程度均升高（P〈0．05）；与I／R组和I组比较，E组血清Cr、CysC、TNF-α、IL-6浓度及肾脏近曲小管坏死程度均降低（P〈0．05），血清IL-10浓度升高（P〈0．05）。I／R组和I组上述各指标比较差异无统计学意义（P〉0．05）。I／R组和I组肾组织病理学损伤严重，E组肾组织病理学损伤明显减轻。结论8％乳化异氟醚预处理可减轻大鼠肾缺血再灌注损伤，其机制可能与抑制全身炎性反应有关。Objective To evaluate the effect of 8% emulsified isoflurane preconditioning on renal isch- emia-reperfusion （I/R） injury in rats. Methods Thirty-two male Sprague-Dawley rats, aged 10-13 weeks, weigh- ing 220-300 g, were randomly divided into 4 groups （ n = 8 each） ： sham operation group （group S） ; I/R group; emulsified isoflurane preconditioning group （group E） ; intralipid preconditioning group （group I）. Renal ischemia was induced by occlusion of the left renal pedicle for 45 rain with atraumatic microclips followed by 3 h reperfusion. 8 % emulsified isoflurane and 30 % intralipid 4 ml. kg-1 . h-1 were infused intravenously for 30 rain followed by 15 rain washout before renal I/R in groups E and I, respectively. Arterial blood samples were taken at 3 h of rcperfu- sion to determine the concentrations of serum creatinine （Cr）, cystatin C （Cys C）, TNF-α, IL-6 and IL-10. The animals were then sacrificed and left kidneys were removed and stained with hematoxylin-eosin for microscopic ex- amination and assessment of necrosis of renal proximal convoluted tubules （0 = normal, 4 = necrosis of whole seg- ment of proximal convoluted tubules） .Results Compared with group S, the serum Cr, Cys C, TNF-α, IL-6 and IL-10 concentrations and severity of necrosis of renal proximal convoluted tubules were significantly increased in groups I/R, E and I （P 〈 0.05）. The serum Cr, Cys C, TNF-α and IL-6 concentrations and severity of necrosis of renal proximal convoluted tubules were significantly lower, while the serum IL-10 concentration was higher in group E than in groups I/R and I （ P 〈 0.05）. There was no significant difference in the indexes mentioned abovebetween groups L and I/R （P 〉 0.05）. The damage to renal tissues was less serious in group E than in groups I/ R and L. Conclusion Preconditioning with 8 % emulsified isoflurane can attenuate renal I/R injury by inhibiting inflammatory responses in rats.

关 键 词：异氟醚 脂肪乳剂 静脉注射用 缺血预处理 再灌注损伤 肾 

分 类 号：R614[医药卫生—麻醉学]