持续低流量复灌注对兔睾丸不全扭转细胞凋亡的影响

Effects of lasted low flow reperfusion postconditioning to incomplete testicular torsion in rabbit

目的：研究持续性低流量复灌注对睾丸不全扭转细胞凋亡的保护作用。方法实验分为轻度睾丸缺血组（A组）和中度睾丸缺血组（B组），两组各分为对照组（分别为AS组和BS组）和后处理组（A1和B1为45s维持组，A2和B2为45s渐增组，A3和B3为30s维持组，A4和B4为30s渐增组）。对照组进行直接复灌注，A1、B1组及A3、B3组分别进行45s和30s的维持相同的低流量复灌注，A2、B2组及A4、B4组分别进行45s和30s的渐增加的低流量复灌注。缺血前与术后3d进行睾丸超声造影，并检测睾丸组织Bcl-2相关X蛋白（Bax）、胱门蛋白酶-3（caspase-3）、凋亡指数（AI）。结果术后3d超声造影与缺血前比较，A4组及B4组的始增时间（AT）、达峰时间（TTP）、峰值强度（PI）、峰值基础强度差（PBD）差异比较均无统计学意义（P ＞0.05）；峰值减半时间（DT/2）缩短，差异具统计学意义（P ＜0.05）。45s渐增组和30s组的AI明显低于对照组和45s维持组（P＜0.01）。30s组Bax和caspase-3均显著低于对照组（P＜0.01）。结论持续低流量复灌注对兔轻、中度睾丸不全扭转具有不同程度的保护作用，保护效果与复灌持续时间和血流增幅有关，以30s渐增低流量复灌保护作用最显著。

Objective Explore the protective effects of lasted low flow reperfusion postconditioning to incomplete testicular torsion apoptosis. Methods The experiment was randomly divided into mild ischemia group（A） and moderate ischemia group （B）, and each group was divided into control groups （AS, BS） and postconditioning groups （A1, A2, A3, A4 and B1、B2、B3、B4）. The control groups got reperfusion completely and immediately, groups A1, B1 and groups A3, B3 got same lasted low flow reperfusion with 45s and 30s, groups A2, B2 and groups A4, B4 got lasted gradually increasing low flow reperfusion with 45s and 30s. Got CEUS appearances before ischemia and postoperation, and analyzed the Bax, caspase-3 and AI of the affected testicle. Results Compared the postoperative parameters with preoperation, the AT, TTP, PI, PBD of the groups A4 and B4 had no change （P〉0.05）, the DT/2 were shorten（P〈0.05）. The AI of groups 2, 3, 4 were significantly lower than control group and group 1（P〈0.01）. The Bax and caspase-3 of postconditioning groups with 30s were significantly lower than control groups （P〈0.01）. Conclusion The lasted low flow reperfusion postconditioning has different protective effects to mild and moderate incomplete testicular torsion in rabbit, and the effect relates to the lasted time of reperfusion and the bloodflow growth, while the effect of lasted gradually increasing low flow reperfusion postconditioning with 30s is the most significant.