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目的探讨远隔缺血后适应是否对大鼠肠道缺血再灌注损伤起保护作用。方法健康雄性昆明种大鼠24只,随机分为假手术组(Con组)、缺血再灌注组(ischemia reperfusion,IR组)和远隔缺血后适应组(remote ischemic postconditioning,RIP组)共3组,每组8只。Con组只给予解剖游离肠系膜上动脉;IR组解剖出肠系膜上动脉,在肠系膜上动脉缺血60min后再灌注120min;RIP组在肠系膜上动脉缺血20min后捆绑左下肢形成4个间隔5min的循环缺血再灌注(共40min),再进行再灌注2h。测定回肠组织中丙二醛(maleiedialdehyde,MDA)和髓过氧化物酶(myeloperoxidase,MPO)的含量;光镜下观察肠道组织形态学改变,对小肠黏膜损伤程度进行评分。结果光镜下观察IR和RIP组有明显的肠道损伤,RIP组肠道损伤程度明显较IR组轻。小肠损伤按Chiu氏评分,RIP组Chiu评分值(2.10±0.63)明显低于IR组(3.20±0.76)(P<0.05)。IR和RIP组回肠组织中MDA和MPO含量明显高于Con组(均P<0.05),而RIP组回肠组织中MDA及MPO含量明显低于IR组(均P<0.05)。结论远隔缺血后适应对小肠缺血再灌注损伤具有显著保护作用,这种远隔器官缺血后适应可能是通过减轻活性氧损伤及炎症反应来保护肠道。
Objective To investigate whether post-ischemic postconditioning can protect intestinal ischemia-reperfusion injury in rats. Methods Totally 24 male Kunming rats were randomly divided into sham operation group (Con group), ischemia reperfusion group (IR group) and remote ischemic postconditioning group (RIP group) 3 groups, 8 in each group. In the Con group, only the superior mesenteric artery was dissected. In the IR group, the superior mesenteric artery was dissected, and the superior mesenteric artery was dissected for 60 minutes and then reperfused for 120 minutes. In the RIP group, the left lower limb was tied 20 minutes after the superior mesenteric artery ischemia, forming 4 cycles of 5 minutes Ischemia and reperfusion (total 40min), followed by reperfusion 2h. The contents of maleicialdehyde (MDA) and myeloperoxidase (MPO) in ileal tissue were determined. The morphological changes of intestinal tissue were observed under light microscope, and the damage of intestinal mucosa was evaluated. Results In the light microscope, the IR and RIP groups showed obvious intestinal damage, and the intestinal injury in RIP group was significantly lighter than that of IR group. According to Chiu’s score, the Chiu score of RIP group (2.10 ± 0.63) was significantly lower than that of IR group (3.20 ± 0.76) (P <0.05). The contents of MDA and MPO in ileal tissue in IR and RIP groups were significantly higher than those in Con group (all P <0.05), while the levels of MDA and MPO in ileum tissue in RIP group were significantly lower than those in IR group (all P <0.05). Conclusion Post-ischemic postconditioning has a significant protective effect on intestinal ischemia-reperfusion injury. This post-ischemic postconditioning may protect the intestine by reducing the reactive oxygen species damage and inflammatory response.