肾脏缺血预处理对麻醉家兔心脏保护的神经机制(英文)

目的　探讨肾神经在肾脏缺血预处理 (RIP)心肌保护中的作用。方法　在麻醉家兔心肌缺血 /再灌注 (MIR)模型上 ,观察MIR和RIP对家兔血流动力学、心肌耗氧量、心外膜电图和心肌梗死范围的影响。结果　在MIR过程中 ,血流动力学指标和心肌耗氧量均明显持续性降低 ;心外膜电图ST段在缺血期明显升高 ,再灌注过程中恢复到基础对照值。单纯MIR时的心肌梗塞范围占缺血心肌的 (55.80± 1.2 5) % ,RIP后心肌梗塞范围为 (3 6.51± 2 .8) % ,较单纯MIR显著减少 (P <0 .0 1)。肾神经切断后对MIR所致的心肌梗死范围无明显影响 ,但可取消RIP对心肌的保护效应。结论　RIP具有心肌保护作用 ,肾短暂缺血 -再灌注所诱发的肾神经传入活动可能参与此心肌保护效应

Involvement of neural mechanism in cardioprotection provided by renal ischemic preconditioniong in anesthetized rabbits

Objective To investigate the role of renal nerve in cardioprotection provided by renal ischemic preconditioning(RIP).Methods The effects of ischemia-reperfusion and RIP on the hemodynamics, myocardial oxygen consumption, epicardial electrography and infarct size were examined in anesthetized rabbit.Results During the 45 min of myocardial ischemia and 180 min of reperfusion, all hemodynamic parameters and myocardial oxygen consumption decreased progressively significantly. Epicardial electrographic ST-segment was elevated significantly during myocardial ischemia and return to baseline progressively in the course of reperfusion. The myocardial infarct size occupied 55.80±1.25% of area at risk,and RIP significantly reduced the myocardial infarct size to 36.51±2.80%(P＜0.01). The renal nerve section (RNS) per se didn't affect myocardial infarct size produced by ischemia-reperfusion, while cardioprotection afforded by RIP was completely abolished by RNS.Conlusion RIP have the protective effect on heart, and activation of renal afferents by transient ischemia-reperfusion play an important role in such a cardioprotection.