CAJ | 학술논문

背景：近年来不少文献报道缺血后调适在多种组织器官包括心肌和骨骼肌都能激发自身内在的对缺血再灌注损伤的保护作用，而且不同方案引发的保护程度有差异，并表现出种属的特异性。 　　目的：比较不同缺血后调适方案对大鼠肢体骨骼肌缺血再灌注损伤的保护作用并优选最佳方案。 　　方法：健康成年雄性SD大鼠随机分为4组(n=9)：缺血再灌注组和不同缺血后调适3个组。各组大鼠均于右侧股动脉进行缺血再灌注实验操作，并分离左侧股动脉作为自身假手术对照，其中缺血再灌注组给予右侧股动脉缺血4h再灌注24h；缺血后调适3个组分别于4h缺血后立即施加4个循环分别为10s再灌/10s缺血、30 s再灌/30 s缺血、1 min再灌/1 min缺血的后调适操作，再灌注24 h。各组实验结束后抽血检测乳酸脱氢酶，取样腓肠肌测算湿干质量(湿/干)比值、检测髓过氧化物酶和丙二醛，取样胫前肌电镜观察骨骼肌病理变化。 　　结果与结论：4个循环的30 s再灌/30 s缺血组湿/干值显著低于缺血再灌注组(P<0.05)，其余2个缺血后调适组与缺血再灌注组差异不明显(P>0.05)。血浆乳酸脱氢酶、组织髓过氧化物酶和丙二醛值缺血后调适3组均低于缺血再灌注组(P<0.05)，缺血后调适组间未见明显差异。4个循环的30 s再灌/30 s缺血组电镜下骨骼肌线粒体嵴的空泡变性程度、肌原纤维结构清晰程度和细胞核完整性较缺血再灌注组均有明显改善，其余2个缺血后调适组超微结构较缺血再灌注组也有不同程度改善。结果提示缺血后调适对大鼠骨骼肌缺血再灌注损伤有保护作用，4个循环30 s再灌/30 s缺血方案的保护效果最明显，可作为进一步实验研究的基础。
배경：근년래불소문헌보도결혈후조괄재다충조직기관포괄심기화골격기도능격발자신내재적대결혈재관주손상적보호작용，이차불동방안인발적보호정도유차이，병표현출충속적특이성。 　　목적：비교불동결혈후조괄방안대대서지체골격기결혈재관주손상적보호작용병우선최가방안。 　　방법：건강성년웅성SD대서수궤분위4조(n=9)：결혈재관주조화불동결혈후조괄3개조。각조대서균우우측고동맥진행결혈재관주실험조작，병분리좌측고동맥작위자신가수술대조，기중결혈재관주조급여우측고동맥결혈4h재관주24h；결혈후조괄3개조분별우4h결혈후립즉시가4개순배분별위10s재관/10s결혈、30 s재관/30 s결혈、1 min재관/1 min결혈적후조괄조작，재관주24 h。각조실험결속후추혈검측유산탈경매，취양비장기측산습간질량(습/간)비치、검측수과양화물매화병이철，취양경전기전경관찰골격기병리변화。 　　결과여결론：4개순배적30 s재관/30 s결혈조습/간치현저저우결혈재관주조(P<0.05)，기여2개결혈후조괄조여결혈재관주조차이불명현(P>0.05)。혈장유산탈경매、조직수과양화물매화병이철치결혈후조괄3조균저우결혈재관주조(P<0.05)，결혈후조괄조간미견명현차이。4개순배적30 s재관/30 s결혈조전경하골격기선립체척적공포변성정도、기원섬유결구청석정도화세포핵완정성교결혈재관주조균유명현개선，기여2개결혈후조괄조초미결구교결혈재관주조야유불동정도개선。결과제시결혈후조괄대대서골격기결혈재관주손상유보호작용，4개순배30 s재관/30 s결혈방안적보호효과최명현，가작위진일보실험연구적기출。
BACKGROUND:Recent studies have shown that ischemic postconditioning can trigger endogenous protection against ischemia/reperfusion injury in various organs including myocardium and skeletal muscle. However, there is variability in protective effects with different protocols and species specificity. OBJECTIVE:To investigate effects of various ischemic postconditioning protocols on rat skeletal muscle ischemia/reperfusion injury and to select an optimal protocol. METHODS:Healthy Adult male Sprague-Dawley rats were randomly al ocated into four groups(n=9):one ischemia/reperfusion injury group and three ischemic postconditioning groups. The rats in ischemia/reperfusion injury group were subjected to 4 hours of main ischemia in the right lower limbs via occlusion of the femoral artery with a clamp, fol owed by 24 hours of reperfusion, and sham surgery in the left lower limbs as self control. The surgical procedures in three ischemic postconditioning groups were same as in ischemia/reperfusion group except additional ischemic postconditioning interventions were applied at the onset of reperfusion after 4 hours of ischemia with three different algorithms respectively:4 cycles of 10 seconds reperfusion/10 seconds ischemia, 4 cycles of 30 seconds reperfusion/30 seconds ischemia, and 4 cycles of 1 minute reperfusion/1 minute ischemia. At the end of 24-hr reperfusion in each group, blood samples were taken from femoral vein for detecting serum lactate dehydrogenase(LDH), and tissue samples from gastrocnemius for measuring wet-dry weight (wet/dry)ratio, enzyme myeloperoxidase and malondialdehyde. Tibialis anterior muscle samples were also col ected for observing the pathological changes in skeletal muscle under electron microscope. RESULTS AND CONCLUSION:The wet/dry ratio was significantly lower in the 30-second reperfusion/30-second ischemia group than in the ischemia/reperfusion injury group (P<0.05). No significant difference was detected between other two ischemic postconditioning groups and ischemia/reperfusion group (P>0.05). Plasma lactate dehydrogenase activity, gastrocnemius myeloperoxidase activity and malondialdehyde contents were lower in the three ischemic postconditioning groups compared to the ischemia/reperfusion injury group (P<0.05). No significant difference was detectable among the three ischemic postconditioning groups. Vacuolar degeneration of skeletal muscle mitochondria, myofibrils structural clarity and integrity of the nucleus were apparently improved in the 30-second reperfusion/30-second ischemia group compared to the ischemia/reperfusion injury group under electron microscope. Ultrastructure changes of the other two ischemic postconditioning groups were improved to different degrees as compared with the ischemia/reperfusion injury group. The results indicate that ischemic postconditioning confers protection against skeletal muscle ischemia/reperfusion injury in the rat model. The protocol of four cycle of 30-second reperfusion/30-second ischemia is optimal, which can be used as a basis for further investigations.