远端缺血后处理防治胃粘膜损伤的实验观察

Protective effects of remote ischemic postconditioning against gastric mucosal lesions:an experimental observation

目的:探讨远端缺血后处理(RIP)对大鼠肢体缺血再灌注(IR)后胃粘膜损伤的保护作用及其机制。方法:采用大鼠肢体IR损伤模型,将雄性Wistar大鼠108只随机分为3组:对照组(C组)、缺血再灌注组(IR组)、远端缺血后处理组(RIP组),每组36只。C组、IR组及RIP组再分为再灌注0 h(T 0)、l h(T 1)、3 h(T 2)、6 h(T 3)、12 h(T 4)及24 h(T 5)6个亚组,每组6只。测定6个时间点血清中乳酸脱氢酶(LDH)、肌酸激酶(CK)活性、TNF-α及IL-10浓度;胃组织中丙二醛(MDA)含量及超氧化物歧化酶(SOD)、髓过氧化物酶(MPO)、黄嘌呤氧化酶(XOD)活性;光镜下观察病理学改变和胃粘膜损伤评分。结果:与C组比较,IR和RIP组血清LDH、CK活性和TNF-α、IL-10浓度升高;胃组织SOD活性降低,MPO、XOD活性和MDA含量升高;光镜见胃粘膜组织损伤及评分升高(P<0.05)。与IR组比较,再灌注后6h RIP组血清LDH、CK活性和TNF-α浓度降低,IL-10浓度升高;胃组织SOD活性升高,XOD、MPO活性和MDA含量降低;胃粘膜组织损伤减轻及评分降低(P<0.05)。结论:远端缺血后处理可通过抗炎症、抗氧化作用,防止肢体IR诱发的胃粘膜损伤,发挥功能性保护效应。

Objective:To investigate the protective effects of remote ischemic postconditioning(RIP)against limb ischemia reperfusion(IR)-induced gastric mucosal injury.Methods:The model of limb ischemia reperfusion injury was used to perform this experiment.108 male Wistar rats,weighing 220~250 g,were randomly divided into 3 groups:group I(Control,C),group II(Ischemic Reperfusion,IR)and groupⅢ(Remote Ischemic postconditioning,RIP)(n=36 each).The C,IR and RIP groups were then re-divided into 6 subgroups(n=6 each)for 0h(T0),1h(T1),3h(T2),6h(T3),12h(T4),or 24h(T5)perfusion respectively.Blood samples were collected to determine serum levels of lactate dehydrogenase(LDH),creatine kinase(CK),tumor necrosis factor(TNF)-αand interleukin(IL)-10 at every time point of reperfusion;gastric tissue samples were similarly collected to determine levels of malondialdehyde(MDA),superoxide dismutase(SOD),xanthine oxidase(XOD)and myeloperoxidase(MPO).Histological changes and gastric mucosal injury were also assessed.Results:Compared with group C,activeities of serum LDH and CK,and concentrations of TNF-αand IL-10 in groups IR and RIP increased;in gastric tissues,activities of MPO and XOD,and MDA content increased,SOD activity decreased;gastric mucosal tissue resulted in injury and the gastric damage score ascended(P<0.05).Compared with group IR,6h after the reperfusion,activities of serum LDH,CK and concentration of TNF-αin RIP group decreased,while concentration of IL-10 elevated;SOD activities in gastric tissues increased,while activities of XOD and MPO and MDA content decreased;histological injury was milder and gastric damage score went down(P<0.05).Conclusion:RIP provides effective functional protection and prevents against gastric mucosal lesions induced by limb IR via anti-inflammatory and antioxidant actions.