Wang Jiang-Mei, Hu Zhi-Yong, Gu Wei-Zhong
Department of Anesthesiology, Children's Hospital of Zhejiang University School of Medicine, Hangzhou 310003, China.
Zhonghua Yi Xue Za Zhi. 2009 Apr 21;89(15):1016-20.
To investigate the protective effects of postconditioning with different concentrations of sevoflurane on renal ischemia-reperfusion (I/R) injury.
The following procedures were performed on 48 male SD rats to establish I/R models: the right kidney and ureter were resected, and the left renal arteries and veins were occluded by atraumatic clamps for 45 min and then the clamps were removed to provide reperfusion for 24 h. And the rats were randomly divided into 4 equal groups; I/R Group, S(1.2) Group inbreathing 1.2% sevoflurane simultaneously since the beginning of reperfusion for 2 h, S(1.8) Group inbreathing 1.8% sevoflurane simultaneously since the beginning of reperfusion for 2 h, and S(2.2) Group inbreathing 2.2% sevoflurane simultaneously since the beginning of reperfusion for 2 h. Another 12 rats underwent resection of the right kidney and ureter and exposure of the left renal arteries and veins only for 45 min. The rates were killed at the end of 24h reperfusion. Blood samples were taken for determination of serum creatinine (Cr) and blood urea nitrogen (BUN). The left kidneys were harvested to undergo microscopy to observe the percentage of pyknotic nuclei in cortical tubular cells. Immunohistochemistry was used to detect the expression of endothelial nitric oxide synthase (eNOS) and inducible nitric oxide synthase (iNOS) in the kidney.
The necrotic rate of renal tubule of the Sham Group was significantly lower than those of the other 4 groups (all P < 0.01), and the necrotic rates of renal tubule of the S(1.2), S(1.8), and S(2.2) Groups were all significantly lower than that of I/R Group (all P < 0.05). The levels of blood Cr and BUN, and the percentage of pyknotic nuclei in cortical tuber cells of I/R, S(1.2), S(1.8), and S(2.2) Groups were all significantly higher than those of Sham Group (all P < 0.05) and these indexes listed above of S(1.2), S(1.8), and S(2.2) Groups were all significantly lower than those of I/R Group (all P < 0.05). However, there were not significant differences in these indexes among S(1.2), S(1.8), and S(2.2) Groups (all P > 0.05). The kidney eNOS and iNOS expression levels of I/R Group were both significantly higher than those of Sham Group (both P < 0.05), and the kidney eNOS and iNOS expression levels of S(1.8) Group were both significantly lower than those of I/R Group (both P < 0.05).
Sevoflurane postconditioning attenuates the renal damage induced by I/R and down-regulates the eNOS and iNOS expression in kidney.Different concentrations do not show different effects.
探讨不同浓度七氟醚后处理对肾缺血再灌注（I/R）损伤的保护作用。
对48只雄性SD大鼠进行以下操作以建立I/R模型：切除右肾和输尿管，用无损伤夹夹闭左肾动静脉45分钟，然后松开夹子进行24小时再灌注。大鼠随机分为4组，每组12只：I/R组；S(1.2)组，再灌注开始时同时吸入1.2%七氟醚2小时；S(1.8)组，再灌注开始时同时吸入1.8%七氟醚2小时；S(2.2)组，再灌注开始时同时吸入2.2%七氟醚2小时。另取12只大鼠仅切除右肾和输尿管，暴露左肾动静脉45分钟。再灌注24小时结束时处死大鼠。采集血样测定血清肌酐（Cr）和血尿素氮（BUN）。取左肾进行显微镜检查，观察皮质肾小管细胞中固缩核的百分比。采用免疫组织化学法检测肾组织中内皮型一氧化氮合酶（eNOS）和诱导型一氧化氮合酶（iNOS）的表达。
假手术组肾小管坏死率显著低于其他4组（均P<0.01），S(1.2)、S(1.8)、S(2.2)组肾小管坏死率均显著低于I/R组（均P<0.05）。I/R组、S(1.2)组、S(1.8)组、S(2.2)组血Cr、BUN水平及皮质肾小管细胞固缩核百分比均显著高于假手术组（均P<0.05），且S(1.2)、S(1.8)、S(2.2)组上述指标均显著低于I/R组（均P<0.05）。但S(1.2)、S(1.8)、S(2.2)组间上述指标差异无统计学意义（均P>0.05）。I/R组肾组织eNOS和iNOS表达水平均显著高于假手术组（均P<0.05），S(1.8)组肾组织eNOS和iNOS表达水平均显著低于I/R组（均P<0.05）。
七氟醚后处理可减轻I/R所致的肾损伤，并下调肾组织中eNOS和iNOS的表达。不同浓度未显示出不同效果。
