Robert René, Vinet Mathieu, Jamet Angéline, Coudroy Rémi
Service de Réanimation Médicale, University of Poitiers, CHU-Poitiers, CIC 1402, 86021, Poitiers Cedex, France.
J Nephrol. 2017 Jun;30(3):393-395. doi: 10.1007/s40620-016-0318-1. Epub 2016 May 19.
Remote ischemic preconditioning may attenuate renal injury and protect the kidney during subsequent inflammatory or ischemic stress. However, the mechanism of such a protection is not well understood. The aim of this study was to investigate the impact of remote ischemic preconditioning on renal resistivity index (RRI) in nine healthy volunteers. In six volunteers, four cycles of 4-min inflation of a blood pressure cuff were applied to one upper arm, followed by 4-min reperfusion with the cuff deflated. RRI was determined using Doppler echography during each cuff deflated period. Measures were also performed in three volunteers without preconditioning. The median value of RRI significantly decreased progressively from 0.59 [0.53-0.62] before the remote conditioning (baseline) to 0.49 [0.46-0.53] at the end of the experiment (p < 0.001) whereas there was no change in controls. In this study, for the first time, we have clearly shown in a small group of subjects that remote ischemic preconditioning can induce a significantly decrease in RRI through increased intra-renal perfusion.
远程缺血预处理可能会减轻肾脏损伤,并在随后的炎症或缺血应激期间保护肾脏。然而,这种保护机制尚未完全明确。本研究的目的是调查远程缺血预处理对9名健康志愿者肾脏阻力指数(RRI)的影响。在6名志愿者中,对一侧上臂使用血压袖带进行4个周期的4分钟充气,然后袖带放气进行4分钟再灌注。在每次袖带放气期间,使用多普勒超声测定RRI。对另外3名未进行预处理的志愿者也进行了测量。RRI的中位数从远程预处理前(基线)的0.59[0.53 - 0.62]显著逐步下降至实验结束时的0.49[0.46 - 0.53](p < 0.001),而对照组则无变化。在本研究中,我们首次在一小群受试者中清楚地表明,远程缺血预处理可通过增加肾内灌注导致RRI显著降低。