CAJ | 학술논문

目的：探究重复性低氧预处理（RHP）对大鼠肾脏缺血再灌注损伤（IRI）所致的肝脏损伤的影响并初步探讨其机制。方法120只雄性SD大鼠随机分为4组（n=30）：低氧预处理手术组（RHP组），低氧预处理假手术组（RHPS组），常压手术组（IRI组）及常压假手术组（S组）。低压氧舱预处理大鼠5 d，建立肾IRI模型，RHP组及IRI组统一切除右肾、夹闭左肾肾门45 min后放开建立肾缺血再灌注模型，而RHPS组及S组仅切除右肾，不进行左肾缺血再灌注处理。于再灌注后2、8、24 h检测血清谷丙转氨酶（ALT）、IL-17A、TNF-α浓度，酶标仪检测肝脏匀浆超氧化物歧化酶（SOD）及一氧化氮（NO）的含量，Western blot检测测肝脏p-PI3K、p-AKT水平，病理组织形态学检查观察肝脏结构变化。结果与IRI组相比，RHP组大鼠再灌注后2、8、24 h病理组织形态学检查显示损伤减轻，血清ALT浓度降低，TNF-α水平于再灌注后24 h降低（P<0.05）肝组织NO含量升高（P<0.05），SOD含量于再灌注后8 h升高（P<0.05）；与S组相比，IRI组及RHP组血清IL-17A浓度均显著升高（P<0.05），但两组间差异无统计学意义（P>0.05）；RHP组P-PI3K及P-AKT表达均高于IRI组（P<0.05），且差异于再灌注后8 h尤为显著（P<0.05）。结论 RHP对大鼠肾脏IRI所致的肝脏损伤具有保护作用，但并非通过抑制IL-17A来实现。
목적：탐구중복성저양예처리（RHP）대대서신장결혈재관주손상（IRI）소치적간장손상적영향병초보탐토기궤제。방법120지웅성SD대서수궤분위4조（n=30）：저양예처리수술조（RHP조），저양예처리가수술조（RHPS조），상압수술조（IRI조）급상압가수술조（S조）。저압양창예처리대서5 d，건립신IRI모형，RHP조급IRI조통일절제우신、협폐좌신신문45 min후방개건립신결혈재관주모형，이RHPS조급S조부절제우신，불진행좌신결혈재관주처리。우재관주후2、8、24 h검측혈청곡병전안매（ALT）、IL-17A、TNF-α농도，매표의검측간장균장초양화물기화매（SOD）급일양화담（NO）적함량，Western blot검측측간장p-PI3K、p-AKT수평，병리조직형태학검사관찰간장결구변화。결과여IRI조상비，RHP조대서재관주후2、8、24 h병리조직형태학검사현시손상감경，혈청ALT농도강저，TNF-α수평우재관주후24 h강저（P<0.05）간조직NO함량승고（P<0.05），SOD함량우재관주후8 h승고（P<0.05）；여S조상비，IRI조급RHP조혈청IL-17A농도균현저승고（P<0.05），단량조간차이무통계학의의（P>0.05）；RHP조P-PI3K급P-AKT표체균고우IRI조（P<0.05），차차이우재관주후8 h우위현저（P<0.05）。결론 RHP대대서신장IRI소치적간장손상구유보호작용，단병비통과억제IL-17A래실현。
Objective To explore the effect of repeated hypoxic preconditioning (RHP) on renal ischemia-reperfusion-induced hepatic dysfunction in rats and the underlying mechanism. Methods A total of 120 normal SD rats were randomly divided into 4 groups (n=40), namely RHP surgical group, RHP sham-operated (RHPS) group, nonhypoxic surgical group (IRI group), and nonhypoxic sham-operated group (S group). The rats in the hypoxic groups were exposed to hypoxia in a hypoxic chamber for 5 days prior to establishment of renal ischemia-reperfusion model by resection of the right kidney and clamping the left renal hilum. Serum alanine aminotransferase (ALT), IL-17A, TNF-α, liver superoxide dismutase (SOD) and nitric oxide (NO) were detected at 2, 8 and 24h after reperfusion, and Western blotting was used to determine the expression of p-PI3K and p-AKT;HE staining was used to observe the structural changes in the liver. Results Compared with IRI group, RHP group showed significantly milder hepatic damage, lower ALT levels and higher NO levels at 2, 8, and 24 after reperfusion (P<0.05);TNF-αlevels were lowered at 24 h (P<0.05) and SOD increased at 8 h after the reperfusion (P<0.05). Compared with S group, IRI group and RHP group showed significantly higher IL-17A levels (P<0.05) but without significant difference between the latter two groups (P>0.05). The expressions of p-PI3K and P-Akt in RHP group were significantly higher than those in IRI group (P<0.05), especially at 8 h after reperfusion (P<0.05). Conclusion Repeated hypoxic preconditioning can attenuate hepatic injury induced by renal ischemia-reperfusion injury in rats.