一次缺血预处理对严重缺血再灌注损伤肾移植模型肾功能恢复的保护效应

Protective effect of once ischemic pretreatment on recovery of renal function in renal transplantation models of severe ischemical reperfusion injury

目的:利用大鼠肾移植模型观察缺血预处理对长时间冷缺血造成严重缺血再灌注损伤的移植肾脏的保护作用。方法:实验于2004-11/2005-06在解放军第四军医大学西京医院泌尿外科实验室完成。将40只Wistar大鼠分为两组,实验组(n=20)接受缺血预处理(15min的热缺血/10min的再灌注),对照组(n=20)不接受上述处理。然后将移植肾脏用UW液低温保存42h后行肾移植术。对早期移植肾功能、移植肾组织中Na+及K+-ATPase及超氧化物歧化酶水平进行检测。结果:①实验组移植肾功能恢复比对照组快,血肌酐水平实验组明显低于对照组[术后第3天:(238.5±24.15),(344.37±27.66)μmol/L;术后第6天:(79.37±8.83),(241.5±11.81)μmol/L,P<0.05或0.01]。②移植肾组织中Na+,K+-ATPase水平术后第3,6天实验组明显高于对照组[术后第3天:(0.186±0.013),(0.078±0.024)nkat/g;术后第6天:(0.196±0.029),(0.082±0.011)nkat/g,P<0.01]。③移植肾组织中超氧化物歧化酶水平术后第3,6天实验组明显高于高于对照组[术后第3天:(1951.3±312.5),(1408.5±182.3)NU/g;术后第6天:(1457.0±171.8),(1044.4±280.2)NU/g,P<0.05]。结论:一次缺血预处理(15min/10min)提高了移植肾组织中Na+及K+-ATPase及超氧化物歧化酶的水平,可以加快严重缺血再灌注损伤移植肾脏的恢复。可以改善长时间冷缺血移植肾的预后。

AIM： To investigate the-protective effect of ischemic pretreatment on rat kidney graft with severe ischemical reperfusion injury due to prolonged cold storage in a rat renal transplantation models. METHODS： The experiment was conducted at the laboratory of Department of Urinary Surgery, Xijing Hospital, Fourth Military Medical University of Chinese PLA from November 2004 to June 2005. Forty Wistar rats were divided into two groups. Prior to 42 hours of cold storage in UW and transplantation, those in the experimental group （n=20） were treated with ischemic pretreatment （hot ischemia for 15 minutes/ reperfusion for 10 minutes）, and those in the control group （n=20） were not given the above-mentioned treatment. Early graft function, Na^＋,K^＋-ATPase and superoxide dismutase （SOD） levels of graft were assessed. RESULTS： ① Renal function in the experimental group recovered quickly than that in the control group, and the level of serum creatinine in the experimental group was lower significantly than that in the control group [at the 3^rd day after operation： （2385±24.15）, （344.37±27.66） μmol/L; at the 6^th day after operation： （79.37 ±8.83）, （241.5 ±11.81）μmol/L,P 〈 0.05 or 0.01]. ② The levels of Na^＋,K^＋-ATPase of graft in the experimental group at the 3^rd and 6^th days after operation were higher obviously than that in the control group [at the 3^rd day after operation： （0.186±0.013）, （0.078±0.024） nkat/g; at the 6^th day after operation： （0.196±0.029）, （0.082±0.011 ） nkat/g,P 〈 0.01]. ③ The level of SOD of graft in the experimental group at the 3^rd and 6^th days after operation were higher obviously than that in the control group [at the 3^rd day after operation： （1 951.3±312.5）, （1 408.5±182.3）NU/g;at the 6^th day after operation： （ 1 457.0±171.8）, （ 1 044.4±280.2）NU/g,P 〈 0.05]. CONCLUSION： One cycle of isehemic pretreatment （15 minutes/10 minutes） enhances the levels of Na^＋, K^＋-ATPase and SOD in graft, accelerates the recovery of renal graft function after severe isehemie reperfusion injury, and ameliorates outcomes of renal transplants with prolonged cold storage.