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前列腺素 E 给药对缺血再灌注损伤期间红细胞和血小板氧化系统活性的影响以及对接受开放式腹主动脉瘤重建术患者术后肾功能的影响。

The effect of PGE administration on the activity of oxidative system in erythrocytes and platelets during ischemia reperfusion injury and on postoperative renal function in patients undergoing open abdominal aortic aneurysm reconstruction.

机构信息

Department of Medical Analytics, Pomeranian Medical University, Szczecin, Poland.

出版信息

J Biol Regul Homeost Agents. 2012 Jul-Sep;26(3):429-38.

PMID:23034262
Abstract

Postoperative decline of renal function remains a common and unpredictable complication after abdominal aortic aneurysm (AAA) reconstruction. The oxidative stress that occurs during perioperative ischemia/reperfusion injury (I/R) may contribute to the development of this complication. In this study, the influence of intraoperative prostaglandin E (alprostadil) administration on erythrocyte and platelet antioxidants as well as postoperative kidney function modulation were verified. AAA patients were randomly divided into control and study/alprostadil groups. Blood samples were collected directly before aortic clamping and 5 min after aortic declamping. Superoxide dismutase, catalase, glutathione, glutathione peroxidase (GPx), and glutathione transferase (GST) were measured using spectrophotometry. During I/R, the activity of catalase (57.14+/-30.65 vs 128.35+/-91.94 U/mg protein; P < 0.009), GPx (0.21+/-0.18 vs 0.35+/-0.21 mU/g protein; P = 0.028), and GST (217.49+/-101.39 vs 310.66+/-88.86 mU/g protein; P = 0.0006) significantly increased in the control group. GST activity before the aortic clamping was significantly lower in the study/alprostadil group (2.84+/-2.28 vs 3.48+/-2.30 U/g Hb; P = 0.05). The activity of the selected antioxidants proved to be of a diagnostic value for predicting postoperative decline in renal function. In conclusion, during I/R after AAA reconstruction, activation of various erythrocyte and platelet antioxidants occurs. Perioperative administration of alprostadil is associated with disruption of this activation.

摘要

术后肾功能下降仍然是腹主动脉瘤(AAA)重建后常见且不可预测的并发症。围手术期缺血/再灌注损伤(I/R)期间发生的氧化应激可能导致这种并发症的发展。在这项研究中,验证了术中前列腺素 E(前列地尔)给药对红细胞和血小板抗氧化剂以及术后肾功能调节的影响。AAA 患者随机分为对照组和研究/前列地尔组。在主动脉夹闭前和主动脉夹闭后 5 分钟直接采集血样。使用分光光度法测量超氧化物歧化酶、过氧化氢酶、谷胱甘肽、谷胱甘肽过氧化物酶(GPx)和谷胱甘肽转移酶(GST)。在 I/R 期间,过氧化氢酶(57.14+/-30.65 对 128.35+/-91.94 U/mg 蛋白;P<0.009)、GPx(0.21+/-0.18 对 0.35+/-0.21 mU/g 蛋白;P=0.028)和 GST(217.49+/-101.39 对 310.66+/-88.86 mU/g 蛋白;P=0.0006)的活性在对照组中显著增加。研究/前列地尔组主动脉夹闭前 GST 活性明显较低(2.84+/-2.28 对 3.48+/-2.30 U/g Hb;P=0.05)。所选抗氧化剂的活性被证明对预测术后肾功能下降具有诊断价值。结论,在 AAA 重建后的 I/R 期间,各种红细胞和血小板抗氧化剂的活性被激活。围手术期前列地尔的给药与这种激活的破坏有关。

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