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[目的]研究缺血后处理对成年兔缺血再灌注肾损伤的影响,并探讨其可能的机制。[方法]18只体重为1.5～2.2kg的日本大耳白兔随机分成3组:假手术组(S组),缺血再灌注组(I/R组),缺血后处理组(IPo组),每组6只。兔均用3%戊巴比妥钠以1ml/kg剂量经耳缘静脉麻醉。采用结扎并切除右肾、分离并夹闭左肾动脉45min,再灌注60min制备肾缺血再灌注模型。S组在麻醉后,开腹,切除右肾,分离左肾动脉,室温下静置105min。IPo组在切除右肾、夹闭左肾动脉45min后,再灌1min,缺血1min,反复4次,再全面恢复血流灌注52min。各组动物均按预定时间点经股动脉取血、观察肾皮质血流、取肾脏标本后处死。除蛋白法测定血浆肌酐(Cr)含量;二乙酰一肟显色法计算血尿素氮(BUN)含量;全自动血流变快测仪测定血液流变学变化;原位末端脱氧核苷酸转移酶标记(TUNEL)法检测肾组织中凋亡细胞,光镜下观察,计算凋亡指数(AI)。[结果]与S组比较,I/R组兔肾血浆Cr和BUN浓度升高;凋亡细胞数明显增多,AI升高(P﹤0.05);血液流变学指标异常;与I/R组比较,IPo组兔肾血浆Cr和BUN浓度降低(P﹤0.05);凋亡细胞数明显减少,AI降低(P﹤0.05);血液流变学指标改善。[结论]缺血后处理可能通过减少细胞凋亡、改善肾脏血液流变学指标,减轻兔缺血再灌注肾损伤。
[Objective] To investigate the effect of ischemic postconditioning on renal ischemia-reperfusion injury in adult rabbits and to explore its possible mechanism. [Methods] Eighteen Japanese white rabbits weighing 1.5-2.2 kg were randomly divided into three groups: sham operation group (S group), ischemia reperfusion group (I / R group), ischemic postconditioning group (IPo group ), 6 in each group. Rabbits were each anesthetized with 3% sodium pentobarbital via the ileal vein at a dose of 1 ml / kg. Ligation and excision of the right kidney were performed to separate and occlude the left renal artery for 45 min and reperfused for 60 min to prepare a model of renal ischemia reperfusion. S group after anesthesia, laparotomy, excision of the right kidney, left renal artery, placed at room temperature for 105min. IPo group in the right kidney excision, left renal artery clamping 45min, reperfusion 1min, ischemia 1min, repeated 4 times, and then fully restored perfusion 52min. Animals in each group were bled by the femoral artery at a predetermined time point, renal cortical blood flow was observed, and the kidney specimens were sacrificed. The content of creatinine (Cr) was measured by the method of deproteinization; the content of blood urea nitrogen (BUN) was calculated by diacetyl-oxime colorimetric method; the hemorheology was measured by automatic blood rheology detector; the terminal deoxynucleotidyl transferase Apoptotic cells in renal tissue were detected by TUNEL method. The apoptosis index (AI) was calculated by light microscopy. [Results] Compared with S group, the concentration of Cr and BUN in rabbit plasma increased in I / R group, the number of apoptotic cells increased significantly, the AI increased (P <0.05), the index of hemorheology was abnormal. Compared with I / R group Compared with control group, the concentrations of Cr and BUN in plasma of rabbits in IPo group decreased (P <0.05), the number of apoptotic cells decreased significantly, AI decreased (P <0.05), and the indexes of hemorrheology improved. [Conclusion] Ischemic postconditioning may improve renal hemorheology and reduce renal ischemia / reperfusion injury by reducing apoptosis.