低氧联合远隔缺血预适应对大鼠缺血再灌注肾损伤的保护作用  

The protective effect of Hypoxic combined with Remote Ischemic Preconditioning on Renal Ischemia Reperfusion Injury in Rats

作　　者：梅霄阳 闫林轩 李丽[1] 王勤章[2] 李应龙 MEI Xiao-yang;YAN Lin-xuan;LI Li;无(Medical College of Shihezi University,Shihezi 832000,China;The First affiliated Hospital of Shihezi university medical college,shihezi 832000,China;The Fifth People's Hospital of Chengfu Chengdu 610000,China)

机构地区：[1]石河子大学医学院,新疆石河子832000 [2]石河子大学医学院第一附属医院,新疆石河子832000 [3]成都市第五人民医院,四川成都610000

出　　处：《吉林医学》2021年第9期2059-2064,共6页Jilin Medical Journal

基　　金：国家自然科学基金资助项目[项目编号:81960188];石河子大学校级课题[课题编号:KX0115]。

摘　　要：目的:探讨低氧预适应联合远隔缺血预适应对大鼠缺血再灌注肾损伤的保护作用及机制。方法:切除右肾并采用无创动脉夹夹闭左侧肾动脉建立IRI模型。将40只雄性SD大鼠随机均分五组:假手术组、缺血再灌注组、低氧预适应组、远隔缺血预适应组、低氧联合远隔缺血预适应组。再灌注24 h收集检测血清肌酐(SCr)、尿素氮(BUN)评估肾功能,HE染色光镜下观察肾组织病理改变,TUNEL法检测细胞凋亡并计算凋亡指数(AI),免疫组化法检测Caspase3和Bcl-2蛋白表达。结果:与缺血再灌注组比较,低氧预适应组、远隔缺血预适应组及联合组SCr、BUN水平、病理损伤程度、细胞凋亡指数AI降低,免疫组化结果显示Bcl-2表达增加而与Caspase3表达减少,差异有统计学意义(P<0.05)。与低氧预适应组及远隔缺血预适应组比较,联合组对肾损伤改善更明显,差异有统计学意义(P<0.05)。结论:低氧及远隔缺血预适应均可减轻大鼠缺血再灌注肾损伤,两者联合具有更强保护效果,其机制可能是通过下调Caspase3和上调Bcl-2蛋白表达,从而抑制细胞凋亡有关。Objective To explore the protective effect and mechanism of hypoxic preconditioning combined with remote ischemic preconditioning on renal ischemia reperfusion injury in rats.Method The right kidney was resected and the left renal artery was clipped with noninvasive artery clamp to establish the IRI model.Forty male SD rats were randomly divided into five groups:the sham group、renal ischemia reperfusion injury group、hypoxic preconditioning group、remote ischemic preconditioning group,hypoxic combined with remote ischemia preconditioning group.Serum creatinine and urea nitrogen were collected to evaluate renal function after reperfusion for 24 hours.Renal tissue were stained by hematoxylin and eosin(HE)and examined under a light microscope.Using TUNEL to detect cell apoptosis and calculate apoptosis index.The protein expression of Caspase3 and Bcl-2 were measured by immunohistochemistry.Results Compared with ischemia reperfusion injury group,The levels of creatinine、urea nitrogen、pathological injury and apoptosis index were decreased in hypoxic preconditioning group、remote ischemic preconditioning group,hypoxic combined with remote ischemic preconditioning group,and the immunohistochemical results showed that the expression of Bcl-2 was increased while the expression of Caspase3 was decreased(P<0.05).Compared with hypoxic preconditioning group and remote ischemic preconditioning group,the combination group improved renal function more significantly(P<0.05).Conclusion Both of the hypoxic preconditioning group and remote ischemic preconditioning group can alleviate renal injury,the combination of the two group has a stronger protective effect,the mechanism may be related to the inhibition of apoptosis by decrese the expression of caspase3 and increse the expression of Bcl-2.

关 键 词：低氧预适应 远隔缺血预适应 缺血再灌注损伤 凋亡 Bcl-2 CASPASE3 

分 类 号：R692[医药卫生—泌尿科学]