间断性跪坐缺血预适应方法的探索及应用  

Exploration and Application of Ischemic Preconditioning Through Intermittent Seiza

作　　者：叶少剑[1] 袁春平[2] 方超 关庆宇 卢小颖 江泓 郑淑园 张培 成梦凡 YE Shaojian;YUAN Chunping;FANG Chao;GUAN Qingyu;LU Xiaoying;JIANG Hong;ZHENG Shuyuan;ZHANG Pei;CHENG Mengfan(School of Medicine,Jianghan University,Wuhan 430056,Hubei,China;School of Physical Education,Jianghan University,Wuhan 430056,Hubei,China)

机构地区：[1]江汉大学医学院,湖北武汉430056 [2]江汉大学体育学院,湖北武汉430056

出　　处：《江汉大学学报（自然科学版）》2019年第1期73-78,共6页Journal of Jianghan University：Natural Science Edition

摘　　要：目的测定并比较两种方法导致下肢缺血再灌注时腓肠肌肌氧含量,建立间断性跪坐缺血预适应的方法,并观察应用该方法产生的远程缺血预适应(RIPC)对前臂皮肤毛细血管脆性的影响。方法1)12人次进行腓肠肌肌氧含量测试:以跪坐法或血压带200 mmHg加压束缚大腿法阻断下肢血流,以缺血5 min后复灌5 min为一个回合进行下肢缺血再灌注,测试受试者腓肠肌同一部位在不同时间点的肌氧含量,连续进行3个回合为实施一次RIPC,比较两种方法下的肌氧含量变化差异。2)61人分为实验组(34人)和对照组(27人)参加毛细血管脆性实验:每天以间断性跪坐实施RIPC 30 min,观察实施前、实施2周(部分人)及4周后血压及前臂皮肤毛细血管脆性的变化。两组中各有14人于实验前后测试血小板。结果1)两种缺血再灌注方法均可引起腓肠肌肌氧含量的规律性改变,即阻断下肢血管时肌氧含量显著降低,恢复血管灌流后肌氧含量迅速恢复至正常值上下。相比于血压带加压束缚法,跪坐时腓肠肌肌氧含量降低更加迅速、完全;2)间断性跪坐4周后,实验组毛细血管脆性显著降低,出血点数量明显减少,与对照组比较差异有统计学意义。血压值及血小板数量在正常范围内无明显改变。结论间断性跪坐通过间断性阻断腘动脉使腓肠肌等下肢组织产生缺血预适应,反复实施4周可以使前臂毛细血管脆性降低,质量改善,是一种简单易行的实施RIPC的有效方法。Objective To measure and compare the tissue oxygenation of gastrocnemius during ischemic and reperfusion(I&R)to lower limbs through two different ways,and to establish a method for remote ischemic preconditioning(RIPC)through intermittent seiza and observe its effect on capillary fragility of forearm skin.Methods 1)12 college students participated in the measurement of tissue oxygenation in gastrocnemius during I&R either through intermittent seiza or blood pressure cuff inflated at 200 mmHg around thigh,taken 5 min reperfusion following 5 min ischemia as a cycle,three such cycles was one RIPC.2)The capillary fragility was checked in the forearm of 61 students whom were randomly into experimental group(34)and control group(27)at pretreatment,two weeks(partial cases)and four weeks after the daily intermittent seiza RIPC.The BP and platelet(platelet 14 cases in each group)were checked while checking the capillary fragility.Results Tissue oxygenation in gastrocnemius changed regularly during I&R in both methods,but seiza could make it decrease more rapidly and thoroughly than that of blood pressure cuff inflation.The skin capillary fragility reduced significantly compared with that of the control group after 4 weeks daily intermittent seiza RIPC.No significant changes were observed for BP and platelet count.Conclusion Intermittent seiza is an effective and easy way for RIPC;it can improve the quality of skin capillary.

关 键 词：间断性跪坐 远程缺血预适应 腓肠肌 肌氧含量 毛细血管脆性 

分 类 号：R540.1[医药卫生—心血管疾病] R364.12[医药卫生—内科学]