缺血后处理对大鼠肢体缺血再灌注后肺损伤的保护作用及其机制

doi:10.13481/j.1671-587x.20160213

摘要/Abstract

摘要：

目的: 观察缺血后处理(I-postC)对大鼠肢体缺血再灌注(LIR)后肺损伤的影响,探讨I-postC的器官保护作用及可能机制。方法: 24只Wistar大鼠随机分为对照组、缺血再灌注组(IR组)和I-postC组(n=8)。橡皮带结扎动物双后肢根部4h后松解橡皮带恢复血流灌注4h,制作大鼠肢体缺血再灌注动物模型。对照组橡皮带松弛环绕大鼠双后肢根部,不阻断血流。I-postC组大鼠在血流再灌注前,行缺血5 min-再灌注5 min,重复3次,再恢复血流灌注4h。实验结束留取血液及肺组织标本,测定各组大鼠血液中性粒细胞CD18阳性细胞百分率、血浆可溶性细胞间黏附分子-1(sICAM-1)和P-选择素(P-selectin)水平以及肺组织髓过氧化物酶(MPO)活性、细胞间黏附分子-1(ICAM-1)和P-selectin水平,测定各组大鼠动脉血气指标氧分压(PaO₂)和二氧化碳分压(PaCO₂),光镜及电镜下观察各组大鼠肺组织的形态学改变。结果: 与对照组比较,IR组大鼠外周血中CD18阳性细胞百分率明显升高(P<0.01);血浆和肺组织中sICAM-1及P-selectin水平均升高(P<0.01);肺组织中MPO活性升高(P<0.01);PaO₂和PaCO₂明显降低(P<0.01)。IR组大鼠肺组织镜下可见肺间质内血管扩张、充血,中性粒细胞浸润,血管周间隙增大,肺泡间隔增宽,肺泡腔内有渗出液,支气管上皮细胞脱落坏死。与IR组比较,I-postC组上述生化指标检测值明显降低(P<0.01),PaO₂和PaCO₂明显升高(P<0.01);血浆及肺组织炎性因子活性降低(P<0.01);镜下可见肺组织损伤减轻。结论: I-postC可通过抑制炎症反应减轻大鼠LIR后的肺损伤。

关键词: 缺血后处理, 炎症反应, 再灌注损伤, 肺组织, 肢体, 大鼠, Wistar

Abstract:

Objective: To observe the effects of ischemic postconditioning (I-postC) on the lung injury after limb ischemia reperfusion(LIR) in the rats, and to investigate the protective effect and the possible mechanisms.Methods: 24 Wistar rats were randomly divided into control group, ischemia-reperfusion group(IR group) and I-postC group(n=8).Referring to routine method in our department, the model rats which underwent 4 h ischemia and 4 h reperfusion of hind limbs were made.In control group, the rubber band around the limb was loose and the blood flow was not blocked.In I-postC group, before reperfusion, ischemia 5 min and reperfusion 5 min were performed in the rats, repeated for 3 times and then perfusion 4 h was taken, The blood and lung tissue from every rat were taken accurately.The percentages of CD18 positive cells in peripheral blood, the levels of soluble intercellular adhesion molecule-1(sICAM-1)and P-selectin in plasma, the myeloperoxidase (MPO) activities in lung tissue, the levels of intercellular adhesion molecule-1 (ICAM-1) and P-selectin in lung tissue of the rats in various groups were detected.The partial pressure of oxygen (PaO₂) and partial pressure of carbon dioxide (PaCO₂) were measured.The morphological changes of lung tissue under light and electron microscopes were observed.Results: Compared with control group, the percentage of CD18 positive cells and the levels of sICAM-1 and P-selectin of the rats in IR groups were increased(P<0.01);PaO₂ and PaCO₂ were decreased significantly;the MPO activity in lung tissue was also significantly increased(P<0.01).The HE staining results showed lung interstitial vascular dilation, congestion, PMN infiltration, the increased gap blood vessel, alveolar septal thickening, alveolar exudation, bronchial epithelial cell shedding and necrosis of the rats in IR group.Compared with IR group, the values of biochemical indicators mentioned above were decreased obviously(P<0.01);PaO₂ and PaCO₂ were increased significantly(P<0.01); the activities of inflammatory factors in plasma and lung tissue were decreased (P<0.01); the pathological changes of lung damage were improved significantly.Conclusion: I-postC can reduce the lung injury after LIR in the rats, and the mechanism may be related to inhibiting the inflammatory reaction.

Key words: ischemic postconditioning, inflammatory reaction, reperfusion injury, lung tissue, limb, rats, Wistar

中图分类号:

R343

赵利军, 李开济, 卢秋玲, 门秀丽. 缺血后处理对大鼠肢体缺血再灌注后肺损伤的保护作用及其机制[J]. 吉林大学学报(医学版), 2016, 42(02): 255-259.

ZHAO Lijun, LI Kaiji, LU Qiuling, MEN Xiuli. Protective effect of ischemia postconditioning on lung injury after limb ischemia reperfusion in rats and its mechanism[J]. Journal of Jilin University Medicine Edition, 2016, 42(02): 255-259.

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