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远端缺血预处理对缺血再灌注后肾功能的保护

The protective effect of remote ischemic preconditioning on renal function after ischemia reperfusion injury
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摘要 目的观察在动物模型中远端缺血预处理(RIPC)对缺血再灌注后肾功能是否有保护作用。方法将雄性SD大鼠24只随机分成4组各6只:空白组,缺血再灌注组,早期RIPC组,晚期RIPC组。空白组仅分离左右肾蒂及肾周组织,45min后关腹;缺血灌注组于大鼠右下肢置松弛止血带30min后分离左右肾蒂和肾周组织,切除右肾并夹闭左肾蒂45min后复灌;早RIPC组和晚RIPC组先行30min RIPC后,两者分别于即刻和24h后采取同缺血灌注组措施。术后24h检测血肌酐(Cr)、尿素氮(BUN),取左肾组织行HE染色病理分析和检测髓过氧化物酶(MPO)、丙二醛(MDA)和超氧化物歧化酶(SOD)。结果缺血灌注组、早RIPC组和晚RIPC组术后24h的Cr、BUN、MPO、MDA、SOD和病理评分各项指标均显著升高(P<0.05)。与缺血灌注组相比,早RIPC组和晚RIPC组有显著保护效果,且晚RIPC组保护效果较早RIPC组好(P<0.05)。结论 RIPC可为缺血再灌注后肾功能提供保护,且晚期保护窗作用较明显,其机制可能与降低氧化应激反应、抑制炎性细胞浸润有关。 Objective To investigate whether remote ischemic preconditioning(RIPC)provides renal protection after ischemia reperfusion injury in animal model.Methods A total of 24 rats were equally divided into four groups:sham group,ischemia reperfusion group(IR group),acute RIPC group,and delayed RIPC group.Sham group received a sham operation;IR group had a right nephrectomy immediately following a 45 min ischemia by applying microvascular on left kidney;acute RIPC group accepted RIPC before surgery;delayed RIPC group received RIPC24 h earlier.Cr,BUN,MPO,MDA,SOD and tubular score were measured 24 h after ischemia reperfusion.Results The levels of Cr,BUN,MPO,MDA,SOD and tubular score were significantly increased in IR,acute RIPC and delayed RIPC groups.Compared with IR group,acute RIPC group and delayed RIPC group had better renal protection,and the delayed group achieved more(P〈0.05).Conclusion RIPC can offer protection for kidney suffering IRI and the effect of delayed RIPC is more obvious,for RIPC may suppress the oxidative stress reaction and inhibit inflammatory cell infiltration.
出处 《现代泌尿外科杂志》 CAS 2016年第5期384-386,390,共4页 Journal of Modern Urology
基金 上海市科委基金资助(No.14ZR1426900)
关键词 远端缺血预处理 缺血再灌注 肾功能 remote ischemic preconditioning ischemia reperfusion renal function
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参考文献18

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