缺血预处理对肢体缺血再灌注损伤影响的临床观察

Clinical observation of the effects of ischemia preconditioning on the extremity ischemia reperfusion injury

目的临床观察缺血预处理对肢体缺血再灌注损伤的作用。方法选择 36例四肢手术需充气止血带加压肢体止血的患者 ,随机分为对照组和缺血预处理组。缺血预处理措施为阻断术肢血流 5分钟 ,然后松止血带 ,恢复血流灌注 5分钟 ,反复 4次。肢体缺血前、再灌注 0 .5、1 .5、3、2 4小时和 72小时分别检测血清丙二醛 (MDA)、肌酸磷酸激酶 (CK)、天冬氨酸氨基转移酶 (AST)和乳酸脱氢酶 (LDH)的含量以及超氧化物歧化酶 (SOD)活性。结果肢体缺血再灌注后各时相点与缺血前比较 ,血清MDA、CK、AST和LDH含量明显低于对照组 ,SOD活性明显高于对照组。

Objective To observe the effects of ischemia preconditioning o n extremity ischemia reperfusion injury.Methods 36 patients unde rgoing operation on the extremities by application of a pneumatic tourniquet wer e divided randomly into two groups: the control group(n=18) and the ischemia preconditioning group(n=18).Ischemia preconditionin g consisted in four cycles of 5min ischemia and 5min reperfusion each.The conten ts of serum MDA,CK,AST and LDH,as well as SOD activity were measured respectivel y before extremity ischemia,0.5h,1.5h,3h,24h and 72h after reperfusion.R esults Compared with the pre-ischemia value,there were significant incr eases in serum MDA,CK,GOT and LDH contents,whereas SOD activity decreased signif icantly at post-reperfusion different time points.The serum MDA,CK,AST and LDH values in the ischemia preconditioning group was significantly lower than that o f the control group,whereas SOD activity in the ischemia preconditioning group w as evidently higher than that of the control group at the same time points of po st reperfusion.Conclusion The ischemia preconditioning can prote ct extremities from ischemia reperfusion injury.