标题：远程缺血预处理对大鼠体外循环后肺损伤的保护作用及机制探讨

      作者：涂 杰，梁东科，刘国锋，梁蓓薇，韦秋英，刘菊梅，张炳东
    (广西医科大学第一附属医院心血管病研究所手术麻醉室，广西 南宁 530021)

      卷次： 2015年26卷9期

      【摘要】 目的 评价远程缺血预处理(RIPC)对大鼠体外循环(CPB)后肺损伤的保护作用并探讨相关机制。
方法 成年雄性SD大鼠60只，随机分为三组(n=20)：假手术组(S组)、CPB组和RIPC+CPB组。S组行麻醉和穿
刺但不行CPB；CPB组采用尾动脉插管灌注，右颈静脉插管引流建立CPB模型；RIPC+CPB组在实施CPB前对后
肢进行RIPC (通过驱血带阻断后肢血流10 min，复灌10 min，两侧后肢交替进行，每侧进行3次)。麻醉复苏后2 h
采集上腔静脉血样，测定血清TNF-α和 IL-6浓度，然后处死大鼠取肺组织，测定肺湿/干重比值(W/D比值)、丙二
醛(MDA)含量和谷胱甘肽过氧化物酶(GSH-px)活性，光镜下观察病理学改变。结果 与 S组比较，CPB组和
RIPC+CPB组血清TNF-α和 IL-6浓度升高，肺组织W/D比值和MDA含量升高，GSH-px活性降低(P<0.05)；与
CPB组比较，RIPC+CPB组血清TNF-α和 IL-6浓度下降，肺组织W/D比值和MDA含量下降，GSH-px活性升高
(P<0.05)。HE染色显示RIPC+CPB组肺组织的形态学损伤轻于CPB组。结论 RIPC可减轻大鼠CPB后肺损
伤，其机制与抑制炎性反应和脂质过氧化反应有关。

      【关键词】 远程缺血预处理；体外循环；肺损伤

      【中图分类号】 R-332 【文献标识码】 A 【文章编号】 1003—6350（2015）09—1256—03


Protective effects of remote ischemic preconditioning on lung injury and its mechanism in rats undergoing
cardiopulmonary bypass.
TU Jie, LIANG Dong-ke, LIU Guo-feng, LIANG Bei-wei, WEI Qiu-ying, LIU Ju-mei,
ZHANG Bing-dong. Operation & Anesthesia Room, Institute of Cardiovascular Disease, the First Affiliated Hospital of
Guangxi Medical University, Nanning 530021, Guangxi, CHINA

【Abstract】 Objective To investigate the protective effects of remote ischemic preconditioning (RIPC) on
lung injury and its mechanism in rats undergoing cardiopulmonary bypass (CPB). Methods Sixty adult male
Sprague-Dawley rats were randomly divided into three groups (n=20 each): sham operation group (group S), group
CPB and group RIPC+CPB. Rats in group S were anaesthetized and cannulated but did not undergoing CPB; rats in
group CPB were cannulated in tail arteries and right jugular vein for CPB; rats in group RIPC+CPB were subjected to
RIPC before CPB. RIPC was used by compressing the two hindlimbs alternately with a tourniquet for three cycles of
10 min ischaemia followed by 10 min reperfusion. The superior vena cava blood samples were collected at 2 h after
anesthesia resuscitation for determination of concentrations of TNF-α and IL-6, and pulmonary tissue were obtained
to observe the wet to dry weight ratio (W/D ratio), concentrations of malondialdehyde (MDA) and activity of glutathi-
one peroxidase (GSH-px). The histopathological changes of lung tissue were also examined. Results Compared with
group S, the plasma concentrations of TNF-α and IL-6, the W/D ratio and concentrations of MDA in lung tissues
were increased, while activity of GSH-px in lung tissues was decreased in group CPB and group RIPC+CPB (P<0.05).
Compared with group CPB, the plasma concentrations of TNF-α and IL-6, the W/D ratio and concentrations of MDA
in lung tissues were decreased, while activity of GSH-px in lung tissues was increased in group RIPC+CPB (P<0.05).
Compared with group CPB, the morphological injury of pulmonary tissue was alleviated in group RIPC+CPB under
HE staining. Conclusion RIPC can reduce the lung injury in rats undergoing CPB. The mechanism is closely related
to inhibiting the inflammatory reaction and lipid peroxidation.

      【Key words】 Remote ischemic preconditioning; Cardiopulmonary bypass; Lung injury
基金项目：广西壮族自治区教育厅科学技术研究项目(编号：LX033)