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目的探讨不同部位缺血预处理对未成熟心肌保护作用。方法采用经典心脏缺血预处理、肾缺血预处理及双下肢缺血预处理动物Langendorff灌注模型比较三种方法对缺血 /再灌(I/R)未成熟心肌损伤的效应。分为5组 :正常对照组(NC,n=6) ,离体心脏仅灌注KH液70min;缺血 /再灌 (I/R ,n=6) ,离体心脏灌注15min转为工作心15min后停灌45min,恢复灌注15min改为工作心30min;心脏缺血预处理组 (IPC,n=6),离体心脏灌注15min转为工作心15min后反复2次缺血5min/再灌5min,然后重复I/R组方法 ;肾缺血预处理组(K -IPC ,n=6) ,反复3次阻断左肾动脉5min,放开5min,然后重复I/R组方法。双下肢缺血预处理组 (DL-IPC ,n=6) ,反复3次捆扎双下肢5min,松开5min,然后重复I/R组方法。以左心室功能恢复、心肌含水量、血清肌酸激酶 (CK)和乳酸脱氢酶 (LDH)漏出率 ,心肌组织ATP和丙二醛 (MDA)含量、超氧化物歧化酶(SOD)活性及电镜作为观察指标。结果IPC、DL-IPC及K-IPC组在左心室功能恢复优于I/R组 (P<0.05) ,在ATP含量、SOD活性及心肌超微结构方面均优于I/R组(P<0.01) ,心肌含水量低于I/R组 (P<0.05) ,在MDA含量、CK、LDH漏出率方面均低于I/R组 (P<0.01)。结论不同部位的非心脏缺血预处理 ,与心脏缺血预处理可诱发同等的心肌保护作用
Objective To investigate the protective effects of different parts of ischemic preconditioning on immature myocardium. Methods The effects of three methods on ischemic / reperfusion (I / R) immature myocardial injury were compared using Langendorff perfusion model of classic heart ischemic preconditioning, renal ischemic preconditioning and bilateral lower extremity ischemic preconditioning. The rats were divided into 5 groups: normal control group (NC, n = 6), isolated hearts were perfused with KH solution only for 70 min; ischemia / reperfusion (I / R, n = 6) After ischemia-reperfusion for 45 minutes, the rats were reperfused for 15 minutes and changed to working heart for 30 minutes. The ischemic preconditioning group (IPC, n = 6) Then the I / R group was repeated. The renal ischemic preconditioning group (K-IPC, n = 6) was used. The left renal artery was blocked for 5 minutes and then left for 5 minutes. The I / R group was then repeated. In both groups, the lower extremities ischemic preconditioning group (DL-IPC, n = 6) was stratified three times for 5 minutes, then loosen for 5 minutes and then repeat the I / R method. Left ventricular function recovery, myocardial water content, serum creatine kinase (CK) and lactate dehydrogenase (LDH) leakage rate, myocardial ATP and malondialdehyde (MDA) content and superoxide dismutase (SOD) activity and Electron microscopy as an indicator. Results The recovery of left ventricular function in IPC, DL-IPC and K-IPC group was better than that in I / R group (P <0.05), and was superior to I / R group in ATP content, SOD activity and myocardial ultrastructure (P < 0.01). The myocardial water content was lower than that of the I / R group (P <0.05), but lower than the I / R group in the content of MDA, the leakage rate of CK and LDH (P <0.01). Conclusions Non-cardiac ischemic preconditioning at different sites can induce the same myocardial protective effect as cardiac ischemic preconditioning