Department of Medical Analytics, Pomeranian Medical University, Szczecin, Poland.
J Biol Regul Homeost Agents. 2012 Jul-Sep;26(3):429-38.
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.
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。