远端缺血预适应对肾脏缺血再灌注损伤的保护作用  

Research on the protective role of remote ischemic preconditioning in kidney ischemia reperfusion injury

作　　者：周昌成 吴然[1] 葛余正[1] 周六化[1] 朱云鹏 朱佳庚[1] 贾瑞鹏[1] Zhou Changcheng;Wu Ran;Ge Yuzheng;Zhou Liuhua;Zhu Yunpeng;Zhu Jiageng;Jia Ruipeng(Department of Urology, Nanjing Hospital Affiliated to Nanjing Medical University （Nanjing First Hospital）, Nanjing 210006, China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)泌尿外科,210006

出　　处：《中华实验外科杂志》2018年第6期1100-1102,共3页Chinese Journal of Experimental Surgery

基　　金：国家自然科学基金（81370853、81570613）

摘　　要：目的探讨远端缺血预适应（RIPC）对肾脏缺血再灌注损伤（IRI）的保护作用及其机制。方法雄性sD大鼠45只，随机分为以下3组：假手术组（Sham组），缺血组（IRI组），远端缺血预适应＋缺血组（RIPC组）。术后24h处死大鼠，收集血液、肾组织及尿液标本，进行血肌酐（SCr）、尿素氮（BUN）检测；评价。肾小管损伤程度并检测环氧化酶2（COX-2）、膜结合型前列腺素E合成酶1（mPGES-1）表达及前列腺素E2（PGE2）生成。结果与IRI组[（3．63±0．54）分]比较，RIPC组[（2．44±0．66）分]肾小管损伤评分明显降低（P=0．001），肾功能（SCr、BUN）亦显著改善（P值分别为0．031和0．004）。免疫组织化学结果显示，RIPC可显著降低肾组织COX-2、PGE2含量（P值分别为0．000和0．034），但对mPGES-1表达无明显影响（P=0．367）。结论RIPC可显著缓解肾脏缺血再灌注损伤程度，COX-2／PGE2通路可能在这一过程中发挥了重要作用。Objective To investigate the protective effects and underlying mechanism of remote is- chemic preconditioning （RIPC） in kidney ischemia reperfusion injury （IRI）. Methods Sprague - Dawley rats were randomly divided into three groups following right - side nephrectomy： Sham-group, IRI - group, RIPC - group. At 24 h after reperfusion, the blood samples, renal tissues and urine were col- lected. The degree of renal injury was evaluated by serum creatinine （SCr）, blood urea nitrogen （BUN） and histological score. We also detected the expression of cyclooxygenase - 2 （ COX - 2） , membrane asso- ciated prostaglandin E synthase - 1 （ mPGES - 1 ） and prostaglandin E - 2 （PGE2）. Results Rats trea- ted with RIPC before ischemia revealed significant improvements in renal function （P value is 0. 031 and 0. 004 respectively） and morphology （IRI： 3.63 ± 0. 54, RIPC： 2. 44 ± 0. 66, P = 0. 001 ）. The results derived from immunohistochemistry revealed that the content of COX - 2 and PGE2 were obviously de- creased in RIPC group than those in IRI group （P value is 0. 000 and 0. 034 respectively）, however, the expression of mPGES - 1 remained no significant change （ P = 0. 367）. Conclusion The results suggested that RIPC could attenuate renal IRI and improve kidney function. The COX -2/PGE2 pathway may play a critical role in this orocess.

关 键 词：远端缺血预适应 缺血再灌注损伤 环氧化酶2 

分 类 号：R699.2[医药卫生—泌尿科学]