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目的:探讨远端缺血预处理对同种异体肾移植术后患者肾功能的影响。方法:选择行同种异体肾移植手术的患者20例,并将其随机分为实验组(S)和对照组(D),每组10例。S组于麻醉后在左下肢绑扎止血带行远端缺血预处理,D组不作缺血预处理。分别于术前(T0)、术后24(T1)、48(T2)、72h(T3)记录患者的尿量;生化检测患者血清尿素氮(BUN)和肌酐(Scr)含量;ELISA检测患者肾损伤分子-1(Kim-1)的含量。结果:两组患者的一般情况比较无统计学差异(P>0.05)。两组患者术后各时点的尿量均较术前显著增加,且S组术后各时点的尿量均明显多于D组增多(P<0.05)。两组患者术后各时点的Scr、BUN含量均较术前下降,两组T1、T2时点的Scr、BUN含量比较差异无统计学意义(P>0.05),但S组术后T3时点血清Scr、BUN水平均明显低于D组(P<0.05)。两组患者术后尿液Kim-1水平均较术前明显下降,S组在T3时点的Kim-1水平显著低于D组(P<0.05)。结论:远端缺血预处理可显著减轻移植肾缺血再灌注损伤,有利于同种异体肾移植患者术后肾功能的恢复。
Objective: To investigate the effect of distal ischemic preconditioning on renal function in patients with allograft renal transplantation. Methods: Twenty patients undergoing allograft renal transplantation were selected and randomly divided into experimental group (S) and control group (D), with 10 in each group. S group was anesthetized in the left lower extremity banding tourniquet remote ischemic preconditioning, D group without ischemic preconditioning. The urine volume of patients was recorded before operation (T0), at 24 (T1), 48 (T2) and 72h (T3) respectively. Serum urea nitrogen (BUN) and creatinine (Scr) Damage molecule-1 (Kim-1) content. Results: There was no significant difference between the two groups (P> 0.05). The urine output of each group after operation was significantly higher than that before operation, and the urine output of S group was significantly higher than that of D group (P <0.05). The Scr and BUN contents of the two groups after operation were significantly lower than those before operation (P> 0.05), but there was no significant difference in Scr and BUN between the two groups at T3 and T3 Serum Scr and BUN levels were significantly lower than the D group (P <0.05). The level of Kim-1 in the urine of the two groups was significantly lower than that before the operation, and the level of Kim-1 in group S at T3 was significantly lower than that in group D (P <0.05). CONCLUSION: Ischemic preconditioning can significantly reduce the ischemia-reperfusion injury in allograft kidneys and promote the recovery of postoperative renal function in allograft recipients.