血红蛋白预处理对肢体缺血再灌注损伤防治作用的临床研究

Clinical study of the effect of hemoglobin preconditioning on the injury of ischemia-reperfusion to limb

目的 探讨血红蛋白 (HGB)预处理对肢体缺血再灌注 (IR)损伤患者的防治作用。方法 选择应用止血带行膝关节关节镜手术患者 2 4例 ,随机分为 3组 :对照 (C)组 ,IR组和HGB预处理 (HGB +IR)组。缺血时间为 1.5h。于缺血前和再灌注后 2h ,采集静脉血 ,检测碳氧血红蛋白 (COHb)、磷酸肌酸激酶 (CPK)、谷草转氨酶 (AST)和乳酸脱氢酶 (LDH)和丙二醛 (MDA)含量的变化。结果 与C组和IR组相比 ,HGB +IR组COHb水平显著增高 (P <0 .0 5 )。与C组相比 ,IR组CPK、AST、LDH和MDA均显著增高 (P <0 .0 5 )。HGB +IR组与IR组相比 ,四者均显著减低 (P <0 .0 5 )。结论 HGB预处理可显著降低肢体的IR损伤 ,是防治肢体IR损伤的有效手段 ,其机制与HGB对HO

Objective To study the protective effect of hemoglobin (HGB) pretretment on the injury of ischemia reperfusion (IR) to the limb.Methods 24 patients treated with knee joint arthroscope operation with a tourniquet placed above the knee joint were divided into 3 groups:control (C).IR and HGB preconditioning (HGB+IR) groups.The ischemic time was 1.5 hours.Venous blood was sampled before ischemia and 2 hours after reperfusion and the levels of carboxyhemoglobin (COHGB),creatine phosphokinase (CPK),glutamic oxalacetic transminase enzyme (GOT),lactate dehydrogenase (LDH) and malondialdehyde (MDA) were detected respectively.Results Compared with the control and IR groups,the level of COHGB increased significantly in HGB+IR group (P<0.05).Compared with the control group,the levels of CPK,GOT,LDH and MDA were increased markedly in IR group (P<0.05).Compared with the IR group,the described 4 markers were all decreased notably (P<0.05) in IR+HGB group.Conclusion HGB preconditioning can relieve the injury of IR to the limb by a possible mechanism of its up regulation to HO CO signal system.