缺血预处理对肢体缺血再灌注时炎性介质的影响

Effects of ischemic preconditioning on inflammation medium in ischemia reperfusion limbs

目的:观察缺血预处理对肢体缺血再灌注损伤的保护作用,并探讨其作用机制。方法:32例胫腓骨切开复位内固定患者被随机分为常规治疗组及缺血预处理组,每组16例。两组分别于再灌注前(手术结束)及再灌注后(手术结束后)30 min、2 h采集外周静脉血标本4 mL检测血小板计数及IL-8、NO、TXB2、6-Keto-PGFlα含量。结果:与再灌注前比较,两组在再灌注后2 h血小板计数及NO含量明显降低(P<0.05,P<0.01),血浆IL-8、TXB2和T/K明显升高(P<0.05,P<0.01);与常规治疗组比较,缺血预处理组相同时相点血小板计数及NO含量明显升高(P<0.05,P<0.01),血浆IL-8、TXB2和T/K明显降低(P<0.05)。结论:肢体缺血再灌注后出现的血小板活化和炎性介质浸润是再灌注损伤的重要机制,缺血预处理能减轻缺血再灌注损伤的程度。

Objective： To observe the effect of ischemic preconditioning on inflammation medium in ischemia reperfusion limbs and to investigate the related mechanisms. Methods： A total of 32 patients undergoing selected limb operation were divided randomly into two groups： control group （Group C, n = 16） and ischemic pre- conditioning group （Group IP, n = 16）. The platelet count and the concentrations of inflammatory medium interleu- kin-8 （IL-8）, nitric oxide （NO） and thromboxane （TXB2） were determined at 30 min and 2 h before and after reperfusion. Results： Compared with those before reperfusion, at 2 h after reperfusion, platelet count and NO decreased significandy （ P 〈 0.05 or P 〈 0.01 ）, but IL-8, TXB2, T/K increased significantly （ P 〈 0.05 ）. Compared with those in Group C, at 2 h after reperfusion, platelet count and NO increased significantly （ P 〈 0.05 or P 〈 0.01 ）, but IL-8, TXB2, T/K decreased significandy （ P 〈 0.05 ）. Conclusion： Platelet activation and inflammation medium soakage may be the important mechanism of ischemic reperfusion injury of limb. Ischemic pre- conditioning can alleviate ischemia reperfusion injury of limbs.