不同缺血后处理方案对大鼠肾脏缺血再灌注损伤的保护作用

Protective effects of different ischemic post-conditioning on renal ischemic reperfusion injury in rats

目的 试建立恰当的大鼠肾脏缺血再灌注损伤（IRI）的缺血后处理模型。方法 选8 ～ 12周健康60只SD雄性大鼠，体质量220 ～ 260 g。随机分为6组：对照组（S组）、缺血再灌注组（IR组）及IR缺血后处理A、B、C、D组，每组10只。S组：分离出双侧肾蒂，仅行右肾蒂结扎和左肾蒂游离；IR组：结扎右侧肾蒂，夹闭左侧肾蒂60 min后恢复灌注；缺血后处理A、B、C、D组在肾脏缺血60 min后分别进行6次（开放10 s ＋ 阻断10 s）、5次（开放20 s ＋ 阻断20 s）、3次（开放10 s ＋ 阻断10 s）、3次（开放2 min ＋ 阻断2 min）的循环，然后充分开放灌注。再灌注24 h后监测肾功能，对肾组织结构损伤程度评分。结果 与IR组相比，A、B、C、D组后处理的血尿素氮（BUN）、血肌酐（SCr）及肾小管损伤程度评分均降低（P 〈 0.05），肾组织损伤明显减轻。处理组中，A、B两组的BUN、SCr及肾小管损伤程度评分相当（P 〉 0.05），且缺血后处理效果优于C、D两组（P 〈 0.05）。结论： 采用缺血后处理A组方法和B组方法均可以成功制作出缺血后处理模型。

Objective To construct the model of ischemic post-conditioning on renal ischemia- reperfusion injury （IRI） in rats. Methods Sixty healthy SD rats（males, body weight 220 - 260 g） were allocated randomly to 6 groups（n = 10）： control group（S）, ischemia-reperfusion0R） group and ischemie post-conditioning groups of A, B, C and D. In group S, the bilateral was separated, the right renal pedicle ligatured and free left renal pedicle. In group IR, the right renal pedicle ligatured, and left renal pedicle was clamped for 60-minute and then reperfused. In groups A, B, C and D, the left renal pedicle was clamped for 60-minute after respective 6 cycles of 10-second ischemia and 10-second reperfusion, 5 cycles of 20-scond ischemia and 20-second reperfusion, 3 cycles of 10- second ischemia and 10-second reperfusion, 3 cycles of 2-minute ischemia and 2-minute reperfusion, then reperfused adequately. After 24-hour reperfusion, the renal function was examined by blood samples and renal injury severity score was performed. Results Compared with group IR, the blood urea nitrogen（BUN）[（16.33 ± 2.75） mmol/L vs （8.65 ± 1.46） mmo]/L, （9.45 ± 2.47） mmol/L, （11.34 ± 1.28） mmol/L, （14.27 ± 1.56） mmol/L, serum creatinine（SCr）[（119.39 ± 19.18） μmol/L vs （61.15 ± 9.31） μmol/L, （68.05 ± 7.41） μmol/L, （82.77 ± 9.32） μmol/L, （99.55 ± 11.68） ± μmol/L] and renal injury severity score[（47.47 ± 7.44） vs （29.05 ± 5.25）, （31.39 ± 5.06）, （37.19 ± 4.95）, （43.00 ± 4.31） ] of groups A, B, C and D were decreased remarkably（P〈 0.05）. There was no significant differences about BUN, SCr and renal injury severity score between group A and B （P 〉 0.05）, and the ischemic postconditioning effect was better than group C and D （P 〈 0.05）. Conclusion It is demonstrated that the method of group A and B could construct the model of ischemic post-conditioning on renal IRI in rats.