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目的:探讨缺血后处理对不同缺血程度的兔睾丸缺血再灌注损伤的作用。方法:42只雄性大白兔随机分成对照组、缺血组(R1、R2、R3组)、后处理组(P1、P2、P3组),每组6只。缺血组、后处理组在超声监测下制成睾丸不同缺血程度模型:R1、P1组睾丸回声均匀,血流轻度减少;R2、P2组睾丸回声增粗,血流明显减少;R3、P3组睾丸出现片状或放射状低回声,血流信号消失。出现上述图像变化后,缺血组给予直接灌流,后处理组于恢复灌流前给予后处理措施,即再灌注30s/缺血30s,反复3次。再灌注前进行超声造影,3d后测定各组组织丙二醛(MDA)、超氧化物歧化酶(SOD)含量。HE染色后光镜下观察睾丸组织和病理学改变,并行Johnsen’s评分和凋亡指数分析;电镜下观察睾丸组织超微结构。结果:再灌注前各造影参数速度参数(β)、峰值时间(TTP)、峰值基础强度差(PBD)、峰值减半时间(DT/2),R1与P1组比较均无显著差异(P>0.05)、R2与P2组比较均无显著差异(P>0.05)、R3与P3组无显影。MDA含量:R1与P1组比较有显著差异(P<0.05),R2与P2组比较有显著差异(P<0.05),R3与P3组比较无显著差异(P>0.05)。SOD活性:R1与P1组比较有显著差异(P<0.05),R2与P2组比较有显著差异(P<0.05),R3与P3组比较无显著差异(P>0.05)。Johnsen’s评分:R1与P1组比较有显著差异(P<0.05),R2与P2组比较无显著差异(P>0.05),R3与P3组比较无显著差异(P>0.05)。凋亡指数:R1与P1组比较有显著差异(P<0.05),R2与P2组比较无显著差异(P>0.05),R3与P3组比较无显著差异(P>0.05)。电镜:P1组超微结构损伤程度较R1组轻,R2与P2组超微结构无明显差异,R3与P3组超微结构无明显差异。结论:缺血后处理可以减轻睾丸缺血再灌注损伤,但是受到缺血程度的影响,并且在病理学和生化学上的表现不一致。
Objective: To investigate the effect of ischemic postconditioning on ischemia-reperfusion injury of testis in rabbits with different degree of ischemia. Methods: Forty-two male rabbits were randomly divided into control group, ischemia group (R1, R2 and R3) and post-treatment group (P1, P2 and P3) The ischemic group and post-treatment group were made into the model of testicular ischemia under ultrasonic monitoring. The testicular echoes of R1 and P1 groups were mild and the blood flow decreased slightly. The testicular echoes of R2 and P2 groups were thick and the blood flow decreased obviously. P3 group testes flake or radial hypoechoic, blood flow signal disappears. After the above image changes, the ischemic group was given direct perfusion, and the post-treatment group was given post-treatment measures before reperfusion, ie 30s of reperfusion / 30s of ischemia, repeated 3 times. Before reperfusion, contrast-enhanced ultrasound was performed. The contents of malondialdehyde (MDA) and superoxide dismutase (SOD) in each group were determined after 3 days. HE staining was used to observe the changes of testis tissue and pathology under light microscope. Johnsen’s score and apoptosis index were analyzed. The ultrastructure of testis was observed under electron microscope. Results: The velocity parameters (β, peak time (TTP), peak basal body strength difference (PBD) and peak half time (DT / 2) of each contrast parameter before reperfusion had no significant difference between R1 and P1 group (P> 0.05). There was no significant difference between R2 and P2 (P> 0.05), and no significant difference between R3 and P3. There was significant difference between the two groups (P <0.05). There was significant difference between R2 and P2 (P <0.05). There was no significant difference between R3 and P3 (P> 0.05). There was significant difference between R1 and P1 (P <0.05). There was significant difference between R2 and P2 (P <0.05). There was no significant difference between R3 and P3 (P> 0.05). Johnsen’s score: There was a significant difference between R1 and P1 (P <0.05). There was no significant difference between R2 and P2 (P> 0.05). There was no significant difference between R3 and P3 (P> 0.05). Apoptosis index: There was significant difference between R1 and P1 (P <0.05), but no significant difference between R2 and P2 (P> 0.05). There was no significant difference between R3 and P3 (P> 0.05). Electron microscopy: The damage of ultrastructure in group P1 was lighter than that in group R1, but there was no significant difference in the ultrastructure of group R2 and P2. There was no significant difference in the ultrastructure of group R3 and P3. CONCLUSION: Ischemic postconditioning can reduce testicular ischemia-reperfusion injury, but it is affected by the degree of ischemia, and its pathological and biochemical findings are inconsistent.