中华器官移植杂志
中華器官移植雜誌
중화기관이식잡지
CHINESE JOURNAL OF ORGAN TRANSPLANTATION
2010年
5期
296-299
,共4页
犬科%肾%缺血预处理%再灌注损伤
犬科%腎%缺血預處理%再灌註損傷
견과%신%결혈예처리%재관주손상
Canidae%Kidney%Ischemic preconditioning%Reperfusion injury
目的 探讨缺血后处理减轻犬肾缺血再灌注损伤的作用及其相关机制.方法 随机将犬分为假手术组、缺血再灌注组和缺血后处理组,每组5只.假手术组:犬麻醉后,取其腹正中切口进入腹腔,游离双侧肾脏,切除右肾后,关腹.缺血再灌注组:手术操作与假手术组相同,仅在切除右肾和游离左肾之后,将左肾动、静脉夹闭60 min,然后开放血管.缺血后处理组:手术操作与缺血再灌注组相同,仅在肾动、静脉被夹闭60 min后,以再灌注(开放血管)30 s、夹闭血管30 s为1个循环,共进行6次循环,然后完全放开血管.分别于术后24、48及72 h采集犬静脉血2 ml,使用全自动生化分析仪测定各组犬血清肌酐(Cr)和尿素氮(BIJN)水平;术后第3天取犬肾组织,采用硫代巴比妥酸法测定丙二醛(MDA)含量,采用黄嘌呤氧化酶法测定超氧化物歧化酶(SOD)活性,采用化学比色法测定髓过氧化物酶(MPO)活性,并观察犬肾组织的病理改变和细胞凋亡情况.结果 术后各时间点,缺血再灌注组、缺血后处理组和假手术组犬的血清Cr和BUN水平均依次降低,3组间比较,差异均有统计学意义(P<0.05).术后第3天,缺血再灌注组、缺血后处理组和假手术组犬肾组织中SOD活性依次升高,而MDA含量和MPO活性均依次降低,3组间比较,差异均有统计学意义(P<0.05).假手术组肾小球和肾小管结构正常,未见明显病理改变;缺血再灌注组肾间质水肿,大量炎症细胞浸润,肾小管上皮细胞刷状缘消失,大量上皮细胞坏死、脱落,管腔扩张,其中可见大量管型;缺血后处理组可见肾间质轻度水肿,肾小管上皮细胞扁平,部分刷状缘消失、坏死,偶见管型,管周血管有少量淤血.假手术组、缺血再灌注组、缺血后处理组犬肾的细胞凋亡指数分别为2.7±1.3、28.4±6.2和15.4±4.1,3组间比较,差异均有统计学意义(P<0.05).结论 缺血后处理能减轻犬肾缺血再灌注损伤,其机制可能与缺血后处理减少氧自由基的产生、抑制细胞凋亡及减少炎症细胞浸润有关.
目的 探討缺血後處理減輕犬腎缺血再灌註損傷的作用及其相關機製.方法 隨機將犬分為假手術組、缺血再灌註組和缺血後處理組,每組5隻.假手術組:犬痳醉後,取其腹正中切口進入腹腔,遊離雙側腎髒,切除右腎後,關腹.缺血再灌註組:手術操作與假手術組相同,僅在切除右腎和遊離左腎之後,將左腎動、靜脈夾閉60 min,然後開放血管.缺血後處理組:手術操作與缺血再灌註組相同,僅在腎動、靜脈被夾閉60 min後,以再灌註(開放血管)30 s、夾閉血管30 s為1箇循環,共進行6次循環,然後完全放開血管.分彆于術後24、48及72 h採集犬靜脈血2 ml,使用全自動生化分析儀測定各組犬血清肌酐(Cr)和尿素氮(BIJN)水平;術後第3天取犬腎組織,採用硫代巴比妥痠法測定丙二醛(MDA)含量,採用黃嘌呤氧化酶法測定超氧化物歧化酶(SOD)活性,採用化學比色法測定髓過氧化物酶(MPO)活性,併觀察犬腎組織的病理改變和細胞凋亡情況.結果 術後各時間點,缺血再灌註組、缺血後處理組和假手術組犬的血清Cr和BUN水平均依次降低,3組間比較,差異均有統計學意義(P<0.05).術後第3天,缺血再灌註組、缺血後處理組和假手術組犬腎組織中SOD活性依次升高,而MDA含量和MPO活性均依次降低,3組間比較,差異均有統計學意義(P<0.05).假手術組腎小毬和腎小管結構正常,未見明顯病理改變;缺血再灌註組腎間質水腫,大量炎癥細胞浸潤,腎小管上皮細胞刷狀緣消失,大量上皮細胞壞死、脫落,管腔擴張,其中可見大量管型;缺血後處理組可見腎間質輕度水腫,腎小管上皮細胞扁平,部分刷狀緣消失、壞死,偶見管型,管週血管有少量淤血.假手術組、缺血再灌註組、缺血後處理組犬腎的細胞凋亡指數分彆為2.7±1.3、28.4±6.2和15.4±4.1,3組間比較,差異均有統計學意義(P<0.05).結論 缺血後處理能減輕犬腎缺血再灌註損傷,其機製可能與缺血後處理減少氧自由基的產生、抑製細胞凋亡及減少炎癥細胞浸潤有關.
목적 탐토결혈후처리감경견신결혈재관주손상적작용급기상관궤제.방법 수궤장견분위가수술조、결혈재관주조화결혈후처리조,매조5지.가수술조:견마취후,취기복정중절구진입복강,유리쌍측신장,절제우신후,관복.결혈재관주조:수술조작여가수술조상동,부재절제우신화유리좌신지후,장좌신동、정맥협폐60 min,연후개방혈관.결혈후처리조:수술조작여결혈재관주조상동,부재신동、정맥피협폐60 min후,이재관주(개방혈관)30 s、협폐혈관30 s위1개순배,공진행6차순배,연후완전방개혈관.분별우술후24、48급72 h채집견정맥혈2 ml,사용전자동생화분석의측정각조견혈청기항(Cr)화뇨소담(BIJN)수평;술후제3천취견신조직,채용류대파비타산법측정병이철(MDA)함량,채용황표령양화매법측정초양화물기화매(SOD)활성,채용화학비색법측정수과양화물매(MPO)활성,병관찰견신조직적병리개변화세포조망정황.결과 술후각시간점,결혈재관주조、결혈후처리조화가수술조견적혈청Cr화BUN수평균의차강저,3조간비교,차이균유통계학의의(P<0.05).술후제3천,결혈재관주조、결혈후처리조화가수술조견신조직중SOD활성의차승고,이MDA함량화MPO활성균의차강저,3조간비교,차이균유통계학의의(P<0.05).가수술조신소구화신소관결구정상,미견명현병리개변;결혈재관주조신간질수종,대량염증세포침윤,신소관상피세포쇄상연소실,대량상피세포배사、탈락,관강확장,기중가견대량관형;결혈후처리조가견신간질경도수종,신소관상피세포편평,부분쇄상연소실、배사,우견관형,관주혈관유소량어혈.가수술조、결혈재관주조、결혈후처리조견신적세포조망지수분별위2.7±1.3、28.4±6.2화15.4±4.1,3조간비교,차이균유통계학의의(P<0.05).결론 결혈후처리능감경견신결혈재관주손상,기궤제가능여결혈후처리감소양자유기적산생、억제세포조망급감소염증세포침윤유관.
Objective To investigate the effects of isehemic postconditioning (IPO) on the acute renal ischemia/reperfusion (I/R) injury in dogs. Methods Fifteen adult male mongrel dogs were randomly divided into three groups with 5 animals in each group. In sham operation group (S), after the dogs were anesthetized, the midline laparotomy was made and right nephrectomy was performed;In I/R group, animals were subjected to the similar surgical procedures, except that the left renal vessels were clamped; In IPO group, the IPO was induced by 6 cycles of reperfusion (30 s) and ischemia (30 s) after 60 min renal ischemia before reperfusion completely. Blood samples were obtained for determination of blood creatinine (Cr) and urea nitrogen (BUN) concentrations before operation and at 24, 48 and 72 h after operation. The dogs were killed at the thirdday after operation and left kidneys were removed for determination of SOD activity and MDA and MPO concentrations.The apoptosis in the nephridial tissue was assessed by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) and apoptotic index (AI) was calculated. The changes of renal tissue were examined by a microscope. Results Blood Cr and BUN concentrations in I/R group, IPO group and S group were decreased in turn after operation (P<0. 05). MDA and MPO concentrations were decreased significantly, SOD activity was significantly increased and AI was decreased significantly in IPO group as compared with I/R group at 72 h after operation (P<0. 05). Microscopic examination showed that there was no renal injury in S group and renal I/R resulted in tubular necrosis, medullary hemorrhage congestion and proteinaceous casts in I/R group. The renal I/R injury was significantly attenuated by IPO. In S group, IPO group and I/R group the renal AI was 2. 7 ±1.3, 28. 4 ± 6. 2 and 15.4±4. 1 respectively (P<0. 05). Conclusion IPO can attenuate renal damage induced by I/R by inhibiting oxidative stress and apoptosis and decreasing inflammation.
