远端缺血预处理对同种异体肾移植术后患者肾功能的影响  

Effect of Remote Ischaemic Preconditioning on Renal Function in Patients Undergoing Allograft Donor Kidney Transplantation

作　　者：汪海涛[1] 孙莹杰[1] 周锦[1] 陈万成[1] 陈克研[1] 张铁铮[1] 

机构地区：[1]沈阳军区总医院麻醉科,辽宁沈阳110840

出　　处：《现代生物医学进展》2014年第26期5115-5118,共4页Progress in Modern Biomedicine

基　　金：辽宁省科技攻关项目(2012225006)

摘　　要：目的:探讨远端缺血预处理对同种异体肾移植术后患者肾功能的影响。方法:选择行同种异体肾移植手术的患者20例,并将其随机分为实验组(S)和对照组(D),每组10例。S组于麻醉后在左下肢绑扎止血带行远端缺血预处理,D组不作缺血预处理。分别于术前(T0)、术后24(T1)、48(T2)、72h(T3)记录患者的尿量;生化检测患者血清尿素氮(BUN)和肌酐(Scr)含量;ELISA检测患者肾损伤分子-1(Kim-1)的含量。结果:两组患者的一般情况比较无统计学差异(P>0.05)。两组患者术后各时点的尿量均较术前显著增加,且S组术后各时点的尿量均明显多于D组增多(P<0.05)。两组患者术后各时点的Scr、BUN含量均较术前下降,两组T1、T2时点的Scr、BUN含量比较差异无统计学意义(P>0.05),但S组术后T3时点血清Scr、BUN水平均明显低于D组(P<0.05)。两组患者术后尿液Kim-1水平均较术前明显下降,S组在T3时点的Kim-1水平显著低于D组(P<0.05)。结论:远端缺血预处理可显著减轻移植肾缺血再灌注损伤,有利于同种异体肾移植患者术后肾功能的恢复。Objeetive： To investigate the effect of remote ischaemic preconditioning on renal function in patients undergoing allograft donor kidney transplantation. Methods： Twenty patients undergoing allograft donor kidney transplantation were randomly assigned to remote ischaemic preconditioning （S） group （n=10） and control （D） group （n=10）. After anesthesia, remote ischemic preconditioning was induced by left lower extremity ischemia using a tourniquet inflated in the S group. Patients in the D group underwent sham placement of the tourniquet wrapped around the left lower extremity without inflation. 24 h urine volume, blood urea nitrogen （BUN）, serum creatinine （Scr） and kidney injury molecule-1 （Kim-1） were detected by ELISA before operation （TO） and at 24 （T1）, 48（T2） and 72h（T3） after operation. Results： No significant difference was observed in the baseline information between two groups （P〉0.05）. After surgery, the urine volume at all time points of patients fi＇om both groups were significantly increased than those before operation （P〈0.05）, which was significantly more in the group S at all time points than those in the group D （P〈0.05）; the BUN, Scr and Kim-1 at all time points of patients from both groups were significantly decreased than before operation （P〈0.05）. No significant difference was found in the BUN, Scr levels at T1 and T2 between two groups, but the serum BUN, Scr levels at T3 of group S were significantly lower than those of group D （P〈0.05）. The urine Kim levels of both groups were significantly lower than those before operation, which at T3 of group S was significantly lower than that of group D （P〈0.05）. Conclusion： Remote ischaemic preconditioning could improve renal function through protecting the kidney against ischemia reperfusion injury in patients undergoing allograft donor kidney transplantation.

关 键 词：远端缺血预处理 肾移植 缺血再灌注损伤 肾损伤分子-1 

分 类 号：R322.61[医药卫生—人体解剖和组织胚胎学] R69[医药卫生—基础医学]