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目的探讨药物对移植肾缺血再灌注损伤(IRI)的防治作用。方法40只健康雄性日本大耳兔随机分为四组:生理盐水对照组、单纯灌注液组、丹参+灌注液组、环孢素A(CsA)+灌注液组。用套管针穿刺左肾动、静脉,形成局部循环,灌注后原位低温保存2h,结扎并切除右肾后使左肾复灌。于术后6、24h分别取血标本,24h后取左肾标本。测定血尿素氮(BUN)、血肌酐(Cr);TUNEL法检测左肾组织的细胞凋亡;免疫组化法测定左肾组织HSP70及NF-κB的表达。结果丹参组和CsA组能有效地改善肾功能(BUN、Cr),前者明显提高超氧化物歧化酶(SOD)活性,减少丙二醛(MDA),而后者明显诱导HSP70的表达。二者均能减少细胞的凋亡。结论IRI是由多因素、多环节共同作用的结果,丹参及CsA能分别从不同方面对IRI进行防治。
Objective To investigate the preventive and therapeutic effects of drugs on renal allograft ischemia-reperfusion injury (IRI). Methods Forty healthy male Japanese white rabbits were randomly divided into four groups: saline control group, simple perfusion group, Salvia miltiorrhiza + perfusion group, cyclosporine A (CsA) + perfusion group. Puncture of the left kidney with a trocar, vein, the formation of local circulation, in situ hypothermia after perfusion preservation 2h, ligation and removal of the right kidney after the left renal reperfusion. Blood samples were taken at 6 and 24 hours after operation, and left kidney samples were taken after 24 hours. Blood urea nitrogen (BUN) and serum creatinine (Cr) were measured. TUNEL method was used to detect the apoptosis of left kidney tissue. Immunohistochemistry was used to detect the expression of HSP70 and NF-κB. Results Salvia miltiorrhiza group and CsA group could effectively improve the renal function (BUN, Cr). The former significantly increased the activity of superoxide dismutase (SOD) and the malondialdehyde (MDA), while the latter obviously induced the expression of HSP70. Both can reduce cell apoptosis. Conclusion IRI is a result of multi-factors and multi-links. Salvia miltiorrhiza and CsA can prevent and treat IRI from different aspects.