高压氧干预对大鼠肾缺血再灌注损伤保护作用的实验研究

The effect of hyperbaric oxygen on renal ischemia-reperfusion injury in rats

目的探讨高压氧（HBO）对大鼠肾缺血再灌注损伤（IRI）的作用及其机制。方法建立大鼠肾IRI模型，54只Wistar大鼠分为假手术组、肾IRI组和HBO治疗组，每组18只。各组分别于再灌注后1，3，5h（每个时间点6只）采血测定血浆肿瘤坏死因子（TNF-α）、丙二醛（MDA）的水平及肾功能[肌酐（SCr）、尿素氮（BUN）]；同时肾组织HE染色后光镜观察病理变化。结果（1）肾IRI组血浆TNF-α、MDA和SCr、BUN的水平明显高于假手术组（P〈0．05）；与。肾IRI组相比，HBO治疗组血浆TNF—α、MDA和SCr、BUN的水平显著降低（P〈0．05）。（2）假手术组各时间点肾小球、肾小管上皮细胞结构正常；肾IRI组随时间延长，肾小球毛细血管、肾小管上皮细胞损伤逐渐加重；HBO治疗后肾损伤的程度明显减轻，再灌注后1h和3h肾损伤减轻的程度明显优于再灌注后5h。结论TNF—α和MDA促进了肾IRI的发生发展。HBO通过减少TNF—OL的生成和防止组织脂质过氧化，明显减轻了肾IRI，保护了肾功能。HBO早期干预更有利于防治肾IRI。

Objective To investigate the effect of hyperbaric oxygen （HBO） on renal ischemia-reperfusion injury （IRI） in rats. Methods The renal IRI models were established in 54 Wistar rats which were randomly divided into three groups：sham operation group,renal IRI group and HBO treatment group（n = 18 in each group）. The levels of plasma tumor necrosis faetor-α （TNF-α）, malonadialdehyde （MDA）,serum ereatine （SCr） and blood urea nitrogen （BUN） were detected at the 1 st,3rd and 5th hours （n = 6, respectively）after reperfusion in each group; moreover, kidney tissue sections stained with HE were used for microscopic pathological examination. Results （1） The levels of plasma TNF-α, MDA, SCr and BUN in renal IRI group were significantly higher than those in sham operation group （P 〈 0.05） ; compared with renal IRI group, the levels of plasma TNF-α, MDA, SCr and reduced significantly in HBO treatment group. （2）At each time point in sham operation group, there was no significant pathologic change in glomeruli and renal tubular epithelial cells. With prolongation of time, the damages of glomerular capillary and renal tubular epithelial cells aggravated gradually in renal IRI group. However, after HBO treatment, the damage of renal tissues alleviated significantly,especially at the 1st and 3rd hours after reperfusion. Conclusions TNF-α and MDA play important roles in development of renal IRI. The damages of renal tissues and renal function improved significantly after HBO treatment through decreasing the production of plasma TNF-α and preventing lipid peroxidation of renal tissues. Early intervention with HBO is useful in preventing renal IRI.