• 1.中國(guó)人民解放軍97中心醫(yī)院普通外科（江蘇徐州 221004）;;
  • 2.第四軍醫(yī)大學(xué)西京醫(yī)院胃腸外科（陜西西安 710032）;

目的對(duì)比研究缺血預(yù)處理(IPC) 、缺血后處理(IPO)以及二者聯(lián)合應(yīng)用(IPC-IPO)對(duì)胰腺缺血再灌注損傷（IRI）的保護(hù)作用。方法建立SD大鼠糖尿病模型，24只糖尿病大鼠用于建立胰腺移植模型，隨機(jī)分為4組，每組6只: I/R組、IPC組、IPO組和IPC-IPO組，另6只糖尿病SD大鼠為假手術(shù)組（SO組），檢測(cè)各組大鼠再灌注前、后血糖水平以及再灌注后2 h移植胰腺組織中SOD和MDA含量，并采用TUNEL法觀察移植胰腺組織細(xì)胞凋亡情況。 結(jié)果各組大鼠再灌注前血糖水平之間的差異均無(wú)統(tǒng)計(jì)學(xué)意義（P gt;0.05）; SO組大鼠再灌注后血糖水平明顯高于其他4組（P lt;0.01）; I/R組、IPC組、IPO組和IPC-IPO組大鼠再灌注后血糖水平均比再灌注前明顯下降（P lt;0.05或P lt;0.01），I/R組又明顯高于后3組（P lt;0.01），而后3組大鼠再灌注后血糖水平間的差異均無(wú)統(tǒng)計(jì)學(xué)意義（P gt;0.05）。 再灌注后IPC組、IPO組和IPC-IPO組大鼠與I/R組比較MDA含量均明顯降低（P lt;0.01），而SOD含量均明顯升高（P lt;0.01）; 與SO組比較，I/R組、IPC 組、IPO組和IPC-IPO組大鼠MDA均明顯升高（P lt;0.01），而SOD含量均明顯降低（P lt;0.01）; IPC 組、IPO組和IPC-IPO組大鼠MDA及SOD含量的差異無(wú)統(tǒng)計(jì)學(xué)意義（P gt;0.05）。 I/R組、IPC 組、IPO組和IPC-IPO組大鼠再灌注后2 h胰腺組織中AI值分別為（47.31±4.52）%、（26.25±3.17）%、（24.73±3.62）%和（25.5±4.15）%，均明顯高于SO組的(3.16±0.53)%，P lt;0.01； IPC組、IPO組和IPC-IPO組大鼠與I/R組比較AI值明顯降低（P lt;0.01）; 而IPC組、IPO組和IPC-IPO組間AI值的差異均無(wú)統(tǒng)計(jì)學(xué)意義（P gt;0.05）。病理組織學(xué)檢查顯示，I/R組大鼠胰腺損傷最為明顯。 結(jié)論IPO和IPC對(duì)胰腺的IRI均有相似的保護(hù)作用。 IPC與IPO聯(lián)合應(yīng)用對(duì)大鼠胰腺IRI和細(xì)胞凋亡的保護(hù)作用無(wú)疊加效應(yīng)。

引用本文： 張召輝,王為忠,李璽,牛萬(wàn)成,陳黨英,張?jiān)泼? IPC、IPO和IPC-IPO對(duì)胰腺冷缺血再灌注損傷保護(hù)作用的對(duì)比研究. 中國(guó)普外基礎(chǔ)與臨床雜志, 2011, 18(8): 844-848. doi: 復(fù)制

1. Murry CE, Jennings RB, Reimer KA. Preconditioning with ischemia: a delay of lethal cell injury in ischemic myocardium [J]. Circulation, 1986, 74(5): 11241136.
2. 蔣厚文, 陳闖, 郝立俊. 大鼠肢體缺血預(yù)處理對(duì)肝缺血/再灌注損傷的保護(hù)作用 [J]. 中國(guó)應(yīng)用生理學(xué)雜志, 2010, 26(4): 502504.
3. Sakamoto K, Nakahara T, Ishii K. RhoRho kinase pathway is involved in the protective effect of early ischemic preconditioning in the rat heart [J]. Biol Pharm Bull, 2011, 34(1): 156159.
4. Kohr MJ, Sun J, Aponte A, et al. Simultaneous measurement of protein oxidation and Snitrosylation during preconditioning and ischemia/reperfusion injury with resinassisted capture [J]. Circ Res, 2011, 108(4): 418426.
5. Zhao ZQ, Corvera JS, Halkos ME, et al. Inhibition of myocardial injury by ischemic postconditioning during reperfusion: comparison with ischemic preconditioning [J]. Am J Physiol Heart Circ Physiol, 2003, 285(2): H579H588.
6. 張召輝, 王為忠, 李璽, 等. 缺血預(yù)處理對(duì)大鼠移植胰腺缺血再灌注損傷的保護(hù)作用及其機(jī)制的研究 [J]. 中國(guó)現(xiàn)代普通外科進(jìn)展, 2010, 13(8): 601604.
7. 張召輝, 王為忠, 李璽, 等. 不同缺血后處理方法對(duì)大鼠胰腺移植的保護(hù)作用及其機(jī)制 [J]. 中國(guó)組織工程研究與臨床康復(fù), 2010, 14(44): 82118214.
8. Lee S, Tung KS, Koopmans H, et al. Pancreaticoduodenal transplantation in the rat [J]. Transplantation, 1972, 13(4): 421425.
9. 冷希圣, 黃萃庭. 大鼠同種異體全胰十二指腸移植治療試驗(yàn)性糖尿病的初步觀察 [J]. 中華實(shí)驗(yàn)外科雜志, 1986, 3(4): 165167.
10. 張召輝, 李璽. 大鼠胰十二指腸移植模型制作的手術(shù)技巧 [J]. 醫(yī)學(xué)研究生學(xué)報(bào), 2004, 17(9): 785787.
11. Yun Y, Duan WG, Chen P, et al. Ischemic postconditioning modified renal oxidative stress and lipid peroxidation caused by ischemic reperfusion injury in rats [J]. Transplant Proc, 2009, 41(9): 35973602.
12. de Rougemont O, Lehmann K, Clavien PA. Preconditioning, organ preservation, and postconditioning to prevent ischemiareperfusion injury to the liver [J]. Liver Transpl, 2009, 15(10): 11721182.
13. Penna C, Tullio F, Moro F, et al. Effects of a protocol of ischemic postconditioning and/or captopril in hearts of normotensive and hypertensive rats [J]. Basic Res Cardiol, 2010, 105(2): 181192.
14. Penna C, Perrelli MG, Raimondo S, et al. Postconditioning induces an antiapoptotic effect and preserves mitochondrial integrity in isolated rat hearts [J]. Biochim Biophys Acta, 2009, 1787(7): 794801.
15. Wang N, Lu JG, He XL, et al. Effects of ischemic postconditioning on reperfusion injury in rat liver grafts after orthotopic liver transplantation [J]. Hepatol Res, 2009, 39(4): 382390.
16. 何桂珍, 董良廣, 周開(kāi)國(guó), 等. 腸道缺血再灌注損傷時(shí)淋巴干結(jié)扎及谷氨酰胺營(yíng)養(yǎng)干預(yù)的作用 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2010, 17(5): 443448.
17. 陳剛, 李學(xué)成, 吳國(guó)慶, 等. 攜帶IL13基因肝干細(xì)胞對(duì)冷缺血大鼠移植肝臟保護(hù)作用的研究 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2010, 17(2): 135141.
18. 秦勇, 黨曉燕. 白藜蘆醇對(duì)重癥急性胰腺炎大鼠腸黏膜缺血再灌注損傷的保護(hù)作用 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2009, 16(10): 819823.
19. 邢軍, 許評(píng), 梁德森, 等. 異搏定對(duì)缺血再灌注大鼠胰腺細(xì)胞凋亡、組織鈣及bcl2、cmyc表達(dá)的影響 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2006, 13(5): 545549.
20. Kin H, Zhao ZQ, Sun HY, et al. Postconditioning attenuates myocardial ischemiareperfusion injury by inhibiting events in the early minutes of reperfusion [J]. Cardiovasc Res, 2004, 62(1): 7485.
21. Vessey DA, Kelley M, Li L, et al. Sphingosine protects aging hearts from ischemia/reperfusion injury: Superiority to sphingosine 1phosphate and ischemic pre and postconditioning [J]. Oxid Med Cell Longev, 2009, 2(3): 146151.
22. Dai AL, Fan LH, Zhang FJ, et al. Effects of sevoflurane preconditioning and postconditioning on rat myocardial stunning in ischemic reperfusion injury [J]. Zhejiang Univ Sci B, 2010, 11(4): 267274.
23. Maslov LN. Role of erythropoietin in the ischemic preconditioning. Postconditioning and regeneration of brain after ischemia [J]. Ross Fiziol Zh Im I M Sechenova, 2010, 96(1): 2642.
24. Prasad SS, Russell M, Nowakowska M. Neuroprotection induced in vitro by ischemic preconditioning and postconditioning: modulation of apoptosis and PI3KAkt pathways [J]. J Mol Neurosci, 2011, 43(3): 428442.
25. Yang XM, Proctor JB, Cui L, et al. Multiple, brief coronary occlusions during early reperfusion protect rabbit hearts by targeting cell signaling pathways [J]. Am Coll Cardiol, 2004, 44(5): 11031110.
26. Halkos ME, Kerendi F, Corvera JS, et al. Myocardial protection with postconditioning is not enhanced by ischemic preconditioning [J]. Ann Thorac Surg, 2004, 78(3): 961969.
  1. 1. Murry CE, Jennings RB, Reimer KA. Preconditioning with ischemia: a delay of lethal cell injury in ischemic myocardium [J]. Circulation, 1986, 74(5): 11241136.
  2. 2. 蔣厚文, 陳闖, 郝立俊. 大鼠肢體缺血預(yù)處理對(duì)肝缺血/再灌注損傷的保護(hù)作用 [J]. 中國(guó)應(yīng)用生理學(xué)雜志, 2010, 26(4): 502504.
  3. 3. Sakamoto K, Nakahara T, Ishii K. RhoRho kinase pathway is involved in the protective effect of early ischemic preconditioning in the rat heart [J]. Biol Pharm Bull, 2011, 34(1): 156159.
  4. 4. Kohr MJ, Sun J, Aponte A, et al. Simultaneous measurement of protein oxidation and Snitrosylation during preconditioning and ischemia/reperfusion injury with resinassisted capture [J]. Circ Res, 2011, 108(4): 418426.
  5. 5. Zhao ZQ, Corvera JS, Halkos ME, et al. Inhibition of myocardial injury by ischemic postconditioning during reperfusion: comparison with ischemic preconditioning [J]. Am J Physiol Heart Circ Physiol, 2003, 285(2): H579H588.
  6. 6. 張召輝, 王為忠, 李璽, 等. 缺血預(yù)處理對(duì)大鼠移植胰腺缺血再灌注損傷的保護(hù)作用及其機(jī)制的研究 [J]. 中國(guó)現(xiàn)代普通外科進(jìn)展, 2010, 13(8): 601604.
  7. 7. 張召輝, 王為忠, 李璽, 等. 不同缺血后處理方法對(duì)大鼠胰腺移植的保護(hù)作用及其機(jī)制 [J]. 中國(guó)組織工程研究與臨床康復(fù), 2010, 14(44): 82118214.
  8. 8. Lee S, Tung KS, Koopmans H, et al. Pancreaticoduodenal transplantation in the rat [J]. Transplantation, 1972, 13(4): 421425.
  9. 9. 冷希圣, 黃萃庭. 大鼠同種異體全胰十二指腸移植治療試驗(yàn)性糖尿病的初步觀察 [J]. 中華實(shí)驗(yàn)外科雜志, 1986, 3(4): 165167.
  10. 10. 張召輝, 李璽. 大鼠胰十二指腸移植模型制作的手術(shù)技巧 [J]. 醫(yī)學(xué)研究生學(xué)報(bào), 2004, 17(9): 785787.
  11. 11. Yun Y, Duan WG, Chen P, et al. Ischemic postconditioning modified renal oxidative stress and lipid peroxidation caused by ischemic reperfusion injury in rats [J]. Transplant Proc, 2009, 41(9): 35973602.
  12. 12. de Rougemont O, Lehmann K, Clavien PA. Preconditioning, organ preservation, and postconditioning to prevent ischemiareperfusion injury to the liver [J]. Liver Transpl, 2009, 15(10): 11721182.
  13. 13. Penna C, Tullio F, Moro F, et al. Effects of a protocol of ischemic postconditioning and/or captopril in hearts of normotensive and hypertensive rats [J]. Basic Res Cardiol, 2010, 105(2): 181192.
  14. 14. Penna C, Perrelli MG, Raimondo S, et al. Postconditioning induces an antiapoptotic effect and preserves mitochondrial integrity in isolated rat hearts [J]. Biochim Biophys Acta, 2009, 1787(7): 794801.
  15. 15. Wang N, Lu JG, He XL, et al. Effects of ischemic postconditioning on reperfusion injury in rat liver grafts after orthotopic liver transplantation [J]. Hepatol Res, 2009, 39(4): 382390.
  16. 16. 何桂珍, 董良廣, 周開(kāi)國(guó), 等. 腸道缺血再灌注損傷時(shí)淋巴干結(jié)扎及谷氨酰胺營(yíng)養(yǎng)干預(yù)的作用 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2010, 17(5): 443448.
  17. 17. 陳剛, 李學(xué)成, 吳國(guó)慶, 等. 攜帶IL13基因肝干細(xì)胞對(duì)冷缺血大鼠移植肝臟保護(hù)作用的研究 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2010, 17(2): 135141.
  18. 18. 秦勇, 黨曉燕. 白藜蘆醇對(duì)重癥急性胰腺炎大鼠腸黏膜缺血再灌注損傷的保護(hù)作用 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2009, 16(10): 819823.
  19. 19. 邢軍, 許評(píng), 梁德森, 等. 異搏定對(duì)缺血再灌注大鼠胰腺細(xì)胞凋亡、組織鈣及bcl2、cmyc表達(dá)的影響 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2006, 13(5): 545549.
  20. 20. Kin H, Zhao ZQ, Sun HY, et al. Postconditioning attenuates myocardial ischemiareperfusion injury by inhibiting events in the early minutes of reperfusion [J]. Cardiovasc Res, 2004, 62(1): 7485.
  21. 21. Vessey DA, Kelley M, Li L, et al. Sphingosine protects aging hearts from ischemia/reperfusion injury: Superiority to sphingosine 1phosphate and ischemic pre and postconditioning [J]. Oxid Med Cell Longev, 2009, 2(3): 146151.
  22. 22. Dai AL, Fan LH, Zhang FJ, et al. Effects of sevoflurane preconditioning and postconditioning on rat myocardial stunning in ischemic reperfusion injury [J]. Zhejiang Univ Sci B, 2010, 11(4): 267274.
  23. 23. Maslov LN. Role of erythropoietin in the ischemic preconditioning. Postconditioning and regeneration of brain after ischemia [J]. Ross Fiziol Zh Im I M Sechenova, 2010, 96(1): 2642.
  24. 24. Prasad SS, Russell M, Nowakowska M. Neuroprotection induced in vitro by ischemic preconditioning and postconditioning: modulation of apoptosis and PI3KAkt pathways [J]. J Mol Neurosci, 2011, 43(3): 428442.
  25. 25. Yang XM, Proctor JB, Cui L, et al. Multiple, brief coronary occlusions during early reperfusion protect rabbit hearts by targeting cell signaling pathways [J]. Am Coll Cardiol, 2004, 44(5): 11031110.
  26. 26. Halkos ME, Kerendi F, Corvera JS, et al. Myocardial protection with postconditioning is not enhanced by ischemic preconditioning [J]. Ann Thorac Surg, 2004, 78(3): 961969.