缺血预处理和后处理对兔移植肺缺血-再灌注损伤的保护作用的比较

Comparation of the protective effection between ischemic preconditioning and ischemic postconditioning on lung transplantation ischemia reperfusion injury in Rabbits

目的比较缺血预处理和缺血后处理2种方法对大白兔肺移植术中缺血-再灌注损伤的保护作用。方法对48只新西兰大白兔建立异体兔肺移植模型,随机等分为缺血再灌组(IR组)、缺血预处理组(IPC组)、缺血后处理组(IPOST组)。监测移植再灌注后60、120 min时氧分压(PaO_2 )的变化,观察各组动物肺组织的病理改变,检测血清中超氧化物歧化酶(SOD)、丙二醛(MDA)、一氧化氮(NO)、肿瘤坏死因子-α(TNF-α)含量,计算肺湿/干重比(W/D)。结果成功制备新西兰大白兔肺移植模型,对缺血-再灌注损伤采用缺血预处理和后处理2种方法干预,病理结果显示,IPC组和IPOST组肺组织的损伤较轻,但IPC组损伤最轻;各组在不同时间点PaO_2 含量差异有统计学意义(P<0.05)。在60、120 min时,IPOST、IPC组PaO_2 高于IR组,IPOST组PaO_2 低于IPC组,差异有统计学意义(P<0.05);3组SOD、MDA、NO、TNF-α及W/D差异有统计学意义(P<0.05)。与IR组比较,IPC组SOD、NO高于IR组,而MDA、TNF-α及W/D低于IR组,差异有统计学意义(P<0.05),IPOST组SOD、NO低于IPC组,而MDA、TNF-α及W/D高于IPC组,差异有统计学意义(P<0.05)。结论缺血预处理及缺血后处理对兔肺移植缺血-再灌注损伤均有保护作用,其中缺血预处理的效果最明显。

Objective To compare the protective effects of ischemic preconditioning and ischemic postconditioning in ischemic reperfusion injury in a rabbit lung transplantation model. Methods 48 rabbits were randomly divided into three groups：ischemia reperfusion,ischemic preconditioning,ischemic postconditioning. The PaO_2 reperfusion after transplantation at 60 min,120 min were monitored. The pathological changes,serum superoxide dismutase（SOD）,malondialdehyde（MDA）,nitric oxide（NO）,tumor necrosis factor alpha（ TNF-α） and lung wet /dry weight ratio were assessed. Results After the model of left lung transplantation were established successfully,ischemia reperfusion injury were treated by two methods of intervention of ischemic preconditioning and postconditioning. Pathology showed that ischemic preconditioning and postconditioning can reduce lung injury,but ischemic preconditioning was better;There was significant difference in PaO_2 content at different times（ P〈0 05）. At 60min,120 min,in IPC and IPOST group,PaO_2 were higher than that in the IR group,which in IPOST group was lower than that in the IPC group,and the differences were statistically significant（ P〈0 05）; SOD,MDA,NO,TNF-α and W / D in 3 groups were statistically significant different（ P〈0 05）. Compared the IR group,SOD and NO in IPC group was higher while MDA,TNF-α and W / D were lower,and the differences were statistically significant（ P〈0 05）. SOD and NO in IPOST group was less than those in the IPC group,while MDA,TNF-α and W /D were higher than those in IPC group,and the differences were statistically significant（ P〈0 05）. Conclusion Both ischemic preconditioning and postconditioning can reduce the ischemia reperfusion injury of transplanted lung,and the effects of ischemic preconditioning is stronger.