脾脏远隔缺血预处理对兔肾脏缺血再灌注损伤的保护作用  

Protective effect of remote spleen ischemic preconditioning on rabbit kidney ischemia reperfusion injury

作　　者：程鹤鹏[1] 李扬[1] 李晓东[1] 田鑫[1] 张广伟[1] 朱朝阳[1] 

机构地区：[1]河南大学淮河医院泌尿外科,开封475099

出　　处：《中华实验外科杂志》2016年第2期460-462,共3页Chinese Journal of Experimental Surgery

摘　　要：目的探讨脾脏远隔缺血预处理对兔肾脏缺血再灌注损伤（RIRI）的保护作用及其机制。方法将36只健康雄性新西兰兔随机分为3组，每组12只。假手术组（Sham组）：仅行开腹，游离双侧肾脏后将左肾切除；缺血再灌注组（I／R组）：在Sham组操作方法的基础上将右肾动、静脉夹闭60min，恢复血供24h；远隔缺血预处理组（RIPC组）：先阻断脾静脉15min后放开，其余操作同I／R组。测定术毕24h血清中肌酐（Cr）和尿素氮（BUN）水平；收集部分右肾组织行病理学评分测定，Western blot检测Toll样受体4（TLR4）和肿瘤坏死因子-α（TNF-α）的表达。结果与Sham组[（98．35±19．07）μmol／L、（8．49±1．35）mmol／L]比较，L／R组Cr、BUN[（354．23±27．49）μmol／L、（30．25±5．69）mmol／L]及RIPC组[（286．52±24．61）μmol／L、（19．78±3．81）mmol／L]水平均明显升高（P〈0．01）；与I／R组比较，RIPC组Cr、BUN水平均明显降低（P〈0．01）。Sham组病理学无明显改变，评分为0～1分，而RIPC组评分中位数（M）为2．0分，四分位间距（IQ）1．5低于I／R组评分（M3．5，IQ1．8，P〈0．05）。TLR4和TNF-α在Sham组（17．21±3．65、25．38±4．09）、RIPC组（93．51±18．04、98．76±19．14）及I／R组（125．93±20．27、147．81±21．03）的表达量依次升高（P〈0．05）。结论脾脏远隔缺血预处理对兔RIRI具有保护作用，其机制可能通过抑制TLR4信号传导通路，减轻RIRI导致的炎性反应有关。Objective To explore the protective effect of remote spleen ischemic preconditioning （RIPC） on rabbit kidney ischemia reperfusion injury （IRI）. Methods Thirty - six healthy male New Zealand rabbits were randomly divided into 3 groups （n = 12 each） ： sham operation group （Sham group） ; IRI group; RIPC group. Serum creatinine （Cr） and urea nitrogen （BUN） levels were measured at 24 h, and the pathological score was determined. Western blotting was used to quantitatively detect the expression of Toll like receptor 4 （TLR4） and tumor necrosis factor alpha （ TNF - α）. Results As compared with Sham group [（98.35 ±19.07） μmol/L and （8.49 ±1.35） mmol/L], Cr and BUN levels in IRI group [（354.23 ±27.49） μmol/L and （30.25 ±5.69） mmol/L] and RIPC group [（286.52 ±24.61） μmol/L and （19. 78 ± 3. 81 ） mmol/L] were significantly increased correspondingly （P 〈 0. 01 ）. The levels of Cr and BUN in RIPC group were significantly decreased as compared with IRI group （P 〈0. 01 ）. There was no significant change of the pathological score in Sham group （0 - 1 score）, and the pathological score in RIPC group [ Interquartile （IQ） 1.5, Median （M） 2. 0 ] was lower than that in the IRI group （ IQ 1.8, M 3.5, P 〈 0. 05 ）. The expression levels of TLR4 and TNF - α in Sham group （ 17.21 ±3.65 and 25. 38 ±4. 09 ） , RIPC group （93.51 ±18.04 and 98.76 ±19. 14） and IRI group （ 125.93 ±20. 27 and 147. 81 ±21.03） were elevated in turn （P 〈 0. 05）. Conclusion The spleen RIPC has protective effect on the IRI of rabbits probably by inhibiting the TLR4 signaling pathway, and alleviating RIRI - induced inflammatory responses.

关 键 词：脾脏 缺血预处理 肾缺血 再灌注损伤 

分 类 号：R692[医药卫生—泌尿科学]