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右美托咪定联合远程缺血预处理对大鼠肾脏缺血再灌注损伤的影响

[Effects of dexmedetomidine in conjunction with remote ischemic preconditioning on renal ischemia-reperfusion injury in rats].

作者信息

Bagcik Emine, Ozkardesler Sevda, Boztas Nilay, Ugur Ergur Bekir, Akan Mert, Guneli Mehmet, Ozbilgin Sule

机构信息

Gordes State Hospital, Anesthesiology and Reanimation, Manisa, Turquia.

Medical Faculty of 9 Eylul University, Anesthesiology and Reanimation, İzmir, Turquia.

出版信息

Rev Bras Anestesiol. 2014 Nov-Dec;64(6):382-90. doi: 10.1016/j.bjan.2014.01.002. Epub 2014 Sep 2.

Abstract

BACKGROUND AND OBJECTIVES

The aim of this study was to evaluate the effects of remote ischemic preconditioning by brief ischemia of unilateral hind limb when combined with dexmedetomidine on renal ischemia-reperfusion injury by histopathology and active caspase-3 immunoreactivity in rats.

METHODS

28 Wistar albino male rats were divided into 4 groups. Group I (Sham, n=7): Laparotomy and renal pedicle dissection were performed at 65th minute of anesthesia and the rats were observed under anesthesia for 130min. Group II (ischemia-reperfusion, n=7): At 65th minute of anesthesia bilateral renal pedicles were clamped. After 60min ischemia 24h of reperfusion was performed. Group III (ischemia-reperfusion+dexmedetomidine, n=7): At the fifth minute of reperfusion (100μg/kg intra-peritoneal) dexmedetomidine was administered with ischemia-reperfusion group. Reperfusion lasted 24h. Group IV (ischemia-reperfusion+remote ischemic preconditioning+dexmedetomidine, n=7): After laparotomy, three cycles of ischemic preconditioning (10min ischemia and 10min reperfusion) were applied to the left hind limb and after 5min with group III.

RESULTS

Histopathological injury scores and active caspase-3 immunoreactivity were significantly lower in the Sham group compared to the other groups. Histopathological injury scores in groups III and IV were significantly lower than group II (p=0.03 and p=0.05). Active caspase-3 immunoreactivity was significantly lower in the group IV than group II (p=0.01) and there was no significant difference between group II and group III (p=0.06).

CONCLUSIONS

Pharmacologic conditioning with dexmedetomidine and remote ischemic preconditioning when combined with dexmedetomidine significantly decreases renal ischemia-reperfusion injury histomorphologically. Combined use of two methods prevents apoptosis via active caspase-3.

摘要

背景与目的

本研究旨在通过组织病理学和活性半胱天冬酶 - 3免疫反应性,评估单侧后肢短暂缺血联合右美托咪定进行远程缺血预处理对大鼠肾缺血再灌注损伤的影响。

方法

将28只雄性Wistar白化大鼠分为4组。第一组(假手术组,n = 7):在麻醉第65分钟进行剖腹术和肾蒂解剖,并在麻醉下观察大鼠130分钟。第二组(缺血再灌注组,n = 7):在麻醉第65分钟夹闭双侧肾蒂。缺血60分钟后进行24小时再灌注。第三组(缺血再灌注 + 右美托咪定组,n = 7):在再灌注第5分钟(腹腔注射100μg / kg)给予右美托咪定,与缺血再灌注组同时进行,再灌注持续24小时。第四组(缺血再灌注 + 远程缺血预处理 + 右美托咪定组,n = 7):剖腹术后,对左后肢进行三个周期的缺血预处理(缺血10分钟和再灌注10分钟),并在第5分钟后与第三组同时进行。

结果

与其他组相比,假手术组的组织病理学损伤评分和活性半胱天冬酶 - 3免疫反应性显著更低。第三组和第四组的组织病理学损伤评分显著低于第二组(p = 0.03和p = 0.05)。第四组的活性半胱天冬酶 - 3免疫反应性显著低于第二组(p = 0.01),第二组和第三组之间无显著差异(p = 0.06)。

结论

右美托咪定药物预处理以及远程缺血预处理联合右美托咪定可在组织形态学上显著降低肾缺血再灌注损伤。两种方法联合使用可通过活性半胱天冬酶 - 3预防细胞凋亡。

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