远端缺血预处理对大鼠肾缺血/再灌注肾功能的影响

目的探讨远端缺血预处理（remote ischemic preconditioning，RIPC）对大鼠肾缺血／再灌注后肾功能的影响。方法SPF级SD大鼠30只，随机分为肾缺血再灌注组（IR组）、远端缺血预处理组（RIPC组）和假手术对照组（s组）。IR组右肾切除，左肾缺血45min，再灌注60min制备肾缺血再灌注模型；RIPC组分离股动脉后夹闭5min，松开动脉夹再灌注5min，反复3次，于1h后建立IR模型；S组麻醉开腹后右肾切除。各组动物于再灌注6h后处死，取血液分离血浆检测肌酐（Scr）、尿素氮（BUN）、IL-1β、TNF—α以及尿液中肾损伤分子-1（Kim—1）的含量；同时取肾组织制作病理切片，HE染色观察各组病理组织学变化。结果IR组肾脏损伤严重，炎症明显，有肾小球肾炎表现，RIPC组肾脏损伤明显减轻。与S组相比，IR组和RIPC组血浆中BUN、Scr、IL-1β、TNF—α以及尿液中Kim-1含量均显著升高（P〈0．05），但RIPC组明显低于IR组（P〈0．05）。结论远端缺血预处理可减轻肾缺血再灌注中的炎性反应，减轻肾功能障碍，具有一定的肾保护作用。

Effect of remote ischaemic preconditioning on renal function in rats with renal ischemia reperfusion

Objective To explore the effect of remote ischemic preconditioning on renal function in rats with renal ischemia-reperfusion injury. Methods SPF male SD rats （n =30） were randomly divided into three equal groups： sham group （group S）, ischemia-reperfusion group （group IR）, and remote ischemic preconditioning group （group RIPC）. For the group IR, the right nephrectomy was performed and the left one had ischemia for 45 min, then returned the blood flow for 60 min. For the group RIPC, to clamp the femoral artery for 5 min, reperfusion 5 rain, and repeated three times, making IR models after 1 h. For the group S, only removed the right kidney by laparotomy after anesthesia. Blood samples were collected at 6 h to determine the Scr,BUN,IL-1β,TNF-α and urinary Kim-1 levels. Histopathological changes of the kidney were observed by pathology using HE staining. Results Histopathological observation showed no obvious changes in the kidneys of group S. Serious renal injuries were found in the group IR, showing obvious inflammation and glomerulonephritis, while the renal injuries were significantly alleviated in the group RIPC, and no serious inflammatory response was detected. Compared with the group S, levels of Scr, BUN, IL-1β, TNF-α and Kim-1 in the group IR and RIPC were significantly increased （P 〈 0.05） ; but they were significant lower in the group IR than in the RIPC group （P 〈0. 05）. Conclusion RIPC can reduce inflammatory reaction, alleviate renal ischemia-reperfusion injury and protect the kidney to some degree.