远隔缺血预处理对围手术期急性肾损伤的保护作用及机制研究进展

Research progress on the protective effect of remote ischemic preconditioning on perioperative acute kidney injury and its mechanism

急性肾损伤(AKI)是围手术期常见并发症,与患者术后其他并发症的发生率和死亡风险增加相关。远隔缺血预处理(RIPC)通过对远离靶器官的远端部位实施多次短暂的缺血/再灌注来增强靶器官对氧化应激的耐受力。大量动物实验已经表明,RIPC可改善肾功能,减轻AKI,提高生存率。然而,在临床研究中关于RIPC减轻AKI的机制仍存在争议。本文就近年来RIPC在肾脏保护中的作用及机制研究进展进行综述,以期为进一步探索围手术期肾保护策略和机制提供参考。

Acute kidney injury(AKI)is a common perioperative complication,which is associated with an increased incidence rate of other postoperative complications and death risk of the patients.Remote ischemic preconditioning(RIPC)performs multiple transient ischemia/reperfusion cycles at remote sites far from the target organs to enhance the tolerance of target organs to oxidative stress.A large number of animal experiments have shown that RIPC can improve kidney function,alleviate AKI,and increase the survival rate of AKI patients.However,there is still controversy about the mechanism of RIPC in alleviating AKI in clinical studies.In this article,the research progress on the role and mechanism of RIPC in renal protection in recent years is reviewed,in order to provide a reference for further exploration of perioperative renal protection strategies and mechanisms.