肢体缺血预处理对兔肾急性缺血再灌注损伤的保护作用

目的观察肢体缺血预处理对肾脏急性缺血再灌注损伤(IRI)能否产生保护作用,并通过肾功能、组织病理学等检测评估其效果。方法(1)建模:40只新西兰大白兔随机分为3个组,假手术(S)组8只,缺血再灌注(IR)组和预处理(LIP)组各16只,后2个组兔采用右肾切除、左肾动静脉阻断1h开放法建立肾脏缺血再灌注模型,S组仅切除右肾,游离左肾动静脉但不阻断。(2)肢体缺血预处理方法:LIP组在阻断前,先以止血带在双下肢根部绑扎,阻断血流5min,完全开放10min,反复4次。(3)评估指标:对比各组兔在再灌注后8、24h和3、7d时肾功能、肾组织MDA含量和SOD活性以及组织病理学差异。结果LIP组再灌注后血清Scr和BUN升高幅度要明显低于IR组(P<0.05),在再灌注后3d内血Scr和BUN明显低于IR组(P<0.05);LIP组再灌注后24h内SOD活性和MDA含量的变化幅度明显低于IR组(P<0.05),且在各时间点SOD活性均明显高于IR组(P<0.05),MDA含量均明显低于IR组(P<0.05);LIP组光镜下病理改变轻于IR组。结论肢体缺血预处理能减轻肾脏缺血再灌注引起的组织病理改变,降低肾组织MDA含量并增加SOD活性,改善肾功能,对急性肾脏IRI起到明显的保护作用。

Protective effect of limb ischemic preconditioning on rabbit kidney following acute ischemia/reperfusion injury

Objective To observe the protective effect of the limb ischemic preconditioning on kidney following acute ischemia/reperfusion injury,and assess its efficacy by renal function and histopathological detection.Methods(1)Modeling: Forty New Zealand rabbits were randomly divided into sham-operated group(S,n=8),ischemia/reperfusion group(IR,n=16),limb ischemic preconditioning group(LIP,n=16).The acute ischemia/reperfusion models of kidney were established in the latter two groups by excising the right kidney and occluding the left renal artery and vein for 1 hour,while S group was only subjected to right nephrectomy and liberation of left renal artery and vein without occlusion of its bloodstream.(2)Method of LIP: Before occusion,both lower limbs of the rabbits in the LIP group were occluded with tourniquet for 5 minutes following by 10 minutes reperfusion for 4 times.(3)Evaluation: The renal function,MDA contents and SOD activity in kidney,and histopathology among the three groups were compared after 8 and 24 hours,3 and 7 days reperfusion.Results The heightening extent of Scr and BUN of LIP group after reperfusion was significantly lower than those of IR group(P<0.05).The Scr and BUN of LIP group within 3 days reperfusion were significantly lower than those of IR group(P<0.05).The changed extent of SOD activity and MDA contents of LIP group after 24 hours reperfusion were significantly lower than those of IR group(P<0.05).The SOD activity of LIP group at each time point was significantly higher than that of IR group(P<0.05),and the MDA contents of LIP group significantly lower than that of IR group(P<0.05).The histopathologic changes of kidney of LIP group were significantly slighter than those of IR group.Conclusion Limb ischemic preconditioning could obviously prevent the histopathological changes caused by renal ischemia/reperfusion injury,cut down the MDA contents,increase the SOD activity and improve the renal function,which shows a significant protective effect on the kidney following acute ischemia/reperfusion injury.