肾缺血再灌注损伤机制及保护研究进展

Research Progress on Mechanism and Protection of Renal Ischemia-reperfusion Injury

本文就5年来对肾缺血再灌注损伤(Renal Ischemic Reperfusion Injury,RIRI)的机制的研究及保护机制进行了综述。肾缺血再灌注损伤的主要分为缺血和再灌注2个阶段,主要病理机制已知与自由基、细胞内钙超载、炎性反应以及细胞凋亡等有关。多是由于RIRI初期自由基的过度富集引起的血管内皮损伤,同时自由基的富集进一步引起炎性反应因子的释放并引起细胞凋亡,新兴的一些研究药物如奥曲肽,蛇床子素等可以通过减少活性氧的生成,抑制炎性反应因子的表达,抑制细胞凋亡来减少肾缺血再灌注损伤,从而保护肾脏。现代医学与传统医药结合应用对RIRI的防治方面的研究显示了一定的优越性,对临床肾移植和急性肾损伤时对肾脏的保护具有一定的提示和借鉴意义。

This paper reviewed the mechanism and protective mechanism of renal ischemic reperfusion injury(RIRI)over the past 5 years.Renal ischemia-reperfusion injury is mainly divided into 2 stages:ischemia and reperfusion.The main pathological mechanisms are known to be related to free radicals,intracellular calcium overload,inflammatory reaction and apoptosis.Most of them are due to the excessive enrichment of free radicals in the early stage of RIRI,and the accumulation of free radicals further causes the release of inflammatory factors and causes apoptosis.Some emerging research drugs such as octreotide and osthole can reduce the production of reactive oxygen species,inhibit the expression of inflammatory factors and inhibit apoptosis to reduce renal ischemia-reperfusion injury,thereby protecting the kidneys.The combination of modern medicine and traditional medicine has shown certain advantages in the prevention and treatment of RIRI.It has certain hints and reference significance for the protection of kidney in clinical kidney transplantation and acute kidney injury.