大鼠肢体缺血预处理对肝缺血/再灌注损伤的保护作用

目的：研究肢体缺血预处理对大鼠肝缺血/再灌注损伤是否具有保护作用。方法：雄性SD大鼠32只,随机分为对照组（S组）;缺血/再灌注组（I/R组）;经典缺血预处理组（IPC组）;肢体缺血预处理组（远端缺血预处理组,RPC组）。S组仅行开腹,不作其他处理;IPC组以肝缺血5min作预处理;RPC组以双后肢缺血5min,反复3次作预处理,2个预处理组及I/R组均行肝缺血1h再灌注3h。取血用于血清谷丙转氨酶（ALT）与血清谷草转氨酶（AST）检测。切取肝组织用于测定湿干比（W/D）、中性粒细胞（PMN）计数及观察显微、超微结构的变化。结果：与I/R组比较,IPC组,RPC组ALT,AST,W/D值,及PMN计数均明显降低（P〈0.01）,肝脏的显微及超微结构损伤减轻。结论：肢体缺血预处理对大鼠肝脏I/R损伤有明显的保护作用,强度与经典缺血预处理相当,其机制可能与抑制肝脏炎症反应、减轻肝脏水肿、改善肝组织微循环有关。     

川芎嗪对肝缺血/再灌注损伤脂质过氧化的影响

目的：观察肝缺血／再灌注损伤时脂质过氧化的动态变化和川芎嗪的影响,并探讨其机制。方法：健康家兔20只,复制肝缺血／再灌注损伤模型。随机分为对照组（n=10）和川芎嗪组（n=10）。连续观察缺血前,缺血25min、再灌注25min、60min和120min时血浆中黄嘌呤氧化酶（XO）活性、超氧化物歧化酶（SOD）活性、丙二醛（MDA）含量和谷丙转氨酶（GPT）活性的动态变化及川芎嗪对不同时限上述指标的影响。结果：川芎嗪组的XO、SOD、MDA和GPT在再灌注的各时限与对照组比较均有显著或非常显著差异（P＜0．05或P＜0．01）。结论：川芎嗪能通过抑制氧自由基的生成,增强氧自由基的清除,对肝缺血／再灌注损伤起着良好的抗脂质过氧化作用。     

肾缺血预处理对心脏缺血／再灌注损伤的保护作用

目的：探讨肾缺血预处理对家兔心脏缺血／再灌注（I／R）损伤的影响及意义。方法：32只大耳白家兔随机分为假手术（SO）、心脏I／R、经典缺血预处理（CIPC）及肾缺血预处理（RIPC）4组。观察各组心肌梗塞面积、左室舒缩功能、心脏超微结构及心律失常发生率的变化。结果：CIPC、RIPC组,心肌梗塞面积、再灌性心律失常发生率较I／R组明显降低,左室舒缩功能明显恢复（P＜0.01）,心脏超微结构损伤明显减轻。结论：RIPC可诱导出与CIPC类似的心脏保护效应。     

SMT对大鼠在体心脏缺血-再灌注损伤超微结构的保护作用

目的：研究ＳＭＴ对心脏缺血－再灌注损伤（ＩＲＩ）心肌超微结构的影响。方法：ＳＤ大鼠１８只,体重３２０￣３８０ｇ,随机分为三组：①缺血－再灌注组（ＩＲ）：夹闭冠状动脉左前降支６０ｍｉｎ,松夹２０ｍｉｎ。②缺血－再灌注＋ＳＭＴ组（ＳＭＴ）：再灌注前５ｍｉｎ,股静脉注射ｉＮＯＳ抑制剂Ｓ－ｍｅｔｈｙｌｉｓｏｔｈｉｏｕｒｅａ ｓｕｌｆａｔｅ（ＳＭＴ ５ｍｇ／ｋｇ ｗ）,余同ＩＲ组;③对照组（Ｃ）：暴露心脏后     

吸入一氧化碳防治肢体缺血／再灌注所致肝脏损伤的实验研究

目的：观察吸入外源性一氧化碳（CO）对肢体缺血／再灌注（I／R）所致肝脏损伤的防治作用。方法：健康SD大鼠100只,随机分为假手术（S）、假手术吸入CO（SC）、I／R、I／R吸入CO（RC）组。通过夹闭股动脉4h、再开放6—72h、10d复制肢体L／R致肝脏损伤模型。S、I／R组吸入普通医用空气,SC、RC组吸入含CO（体积分数为0．05％）的医用空气。光镜观察肝组织病理学变化,全自动生化分析仪检测血谷丙转氨酶（GPT）,流式细胞仪检测肝细胞凋亡百分比及bax、bcl-2的表达水平。结果：S组与SC组比较,各项观察指标无显著差别;与SC组比较,I/R及RC组肝组织呈病理改变,血清GPT及肝细胞凋亡百分比明显升高;I／R组肝细胞bax蛋白的表达水平明显升高。和L／R组相比。RC组肝组织损伤程度减轻,血清GPT、肝细胞凋亡百分比及bax蛋白的表达水平明显降低,而肝细胞bcl-2蛋白的表达水平显著升高。结论：吸入适量外源性CO对肢体I／R所致肝脏损伤有防治效应。     

N—acetylserotonin对肝缺血再灌注小鼠氧化应激损伤的保护作用

目的探讨NAS对肝缺血再灌注所诱导的脂质过氧化损伤产生的保护作用。方法采用夹闭肝蒂法30min、再灌注6h制作肝缺血再灌注模型,冰冻切片,HE染色,光学显微镜下观察肝细胞形态结构的变化;比色法检测损伤后血清中谷丙转氨酶（ALT）水平及肝组织中超氧化物歧化酶（SOD）、丙二醛（MDA）、谷胱甘肽过氧化物酶（GSH—Px）的含量。结果夹闭肝蒂30min、再灌注6h后,肝小叶结构紊乱、肝血窦淤血,其间有白细胞浸润、肝细胞出现变性、坏死;血清中ALT水平升高,肝组织中s0D和GSH—Px的含量降低,MDA升高;NAS可减少缺血再灌注后血清ALT的释放,使肝组织中SOD和GSHPx的含量升高,MDA的含量降低;NAS＋Luz可逆转NAS的这一作用。结论NAS对肝缺血再灌注小鼠的氧化应激损伤具有保护作用。     

富氢盐水对缺血再灌注损伤保护作用的研究进展

缺血是临床疾病中最常见原因之一,缺血再灌注损伤是脑缺血等器官缺血最重要病理生理过程,缺血性疾病通常可在早期采用溶栓和抗自由基损伤等技术来防治。氢气目前仅作为保健品使用,尚未应用于临床,富氢盐水作为一种含氢注射液,能够减少缺血再灌注损伤,减轻炎性反应,抑制细胞凋亡,减少氧化应激,从而对器官起到明确的保护作用。缺血再灌注损伤在临床发生率极高,富氢盐水作为一种能够普及、应用方便的保护剂,具有广大的应用前景。富氢盐水用于防治缺血再灌注导致的组织损伤和器官功能障碍的可能机制为降低氧化应激、减少细胞凋亡和抑制炎性因子上调。     

胆红素对大鼠肺脏缺血再灌注损伤保护作用的研究

目的探讨胆红素对实验性大鼠肺缺血再灌注损伤的保护作用并探讨其发生的机制。方法60只健康Wistar大鼠随机分为3组：手术对照（C）组,缺血再灌注（IR）组,胆红素干预（B）组。每组分别于缺血第45min、再灌注30min、60min、120min4个时点,经左房放血处死大鼠,观察肺组织病理形态变化,检测血浆丙二醛（MDA）、超氧化物歧化酶（SOD）的含量,测定肺组织干/湿重（D/W）比值,TUNEL法测定肺组织中细胞凋亡指数（AI）。结果①肺组织病理变化：缺血再灌注后IR组肺组织损伤进行性加重,毛细血管充血、肺泡间隔炎性细胞浸润、肺泡腔内炎性细胞及炎性液体渗出显著,B组肺组织充血、水肿、炎性细胞浸润较IR组减轻。②血浆MDA含量：IR组在缺血再灌注后血浆MDA含量明显增加,较C组和B组同时点均显著增高（P〈0.01）,而B组的MDA含量在缺血再灌注过程中的变化无显著性意义;③血浆SOD含量：经缺血再灌注后,IR和B组血浆SOD含量较C组同时点均显著下降（P〈0.05）,B组减少的程度明显小于IR组（P〈0.05）;④肺组织D/W比值：经缺血和再灌注后,IR组和B组的肺组织D/W比值都呈进行性下降（再灌注60、120minvs缺血45min,P〈0.01）;B组下降幅度明显小于IR组（再灌注60、120min时,B组vsIR组,P〈0.05）;⑤肺组织细胞AI的变化：IR组及B组缺血再灌注后均可见肺组织细胞凋亡现象,但与IR组相比,B组相同时点的肺组织细胞凋亡数显著减少（P〈0.05）;结论胆红素对于实验性大鼠肺脏缺血再灌注损伤具有一定的保护作用,其作用机制与清除氧自由基、抗氧化及抗细胞凋亡有关。     

RAGE与肝缺血再灌注损伤间的关系

晚期糖化终末产物受体(receptor for advanced glycation end product,RAGE)是一种单穿膜受体,同时也是一种多配体受体,属于免疫球蛋白超家族的成员。其配体包括高速泳动族框1蛋白质(high mobility group box 1,HMGB1)、晚期糖化终末产物(advanced glycation end product,AGE)、S100/钙粒蛋白(calgranulin)及β淀粉样肽等。在肝脏中,RAGE主要表达于巨噬细胞与树突状细胞上。RAGE一旦被激活,就会通过一系列的信号传导,诱导这些细胞释放出多种促炎症的物质,并引起中性粒细胞沉积,产生瀑布式的炎症反应链。肝脏的缺血再灌注(ischemia/reperfusion,I/R)损伤作用机制繁多。其中RAGE作为一个关键的调节点,各种外来和内在的因素都可以通过作用于RAGE从而影响炎症反应。现就肝脏I/R损伤与RAGE之间关系做一综述。     

缺血预处理对大鼠肺缺血/再灌注损伤的保护作用

目的 :观察缺血预处理 (IPC)对大鼠肺缺血 /再灌注 (I/R)损伤的保护作用 ,并初步探讨其作用机制。方法 :建立离体大鼠肺灌流模型 ,36只wistar大鼠随机分为对照组、I/R组和IPC组 ,处理完毕后分别测定平均肺动脉压(MPAP)、肺组织湿 /干重比、支气管肺泡灌洗液中肺表面活性物质磷脂及表面张力改变 ,肺组织标本送电镜检查。结果 :①电镜下观察IPC组肺损伤明显减轻。②肺组织湿 /干重比值IPC组为 4.41± 0 .2 4,显著低于I/R组 ,但仍高于缺血前 (P <0 .0 1) ;③IPC组大鼠缺血 1h后MPAP为 ( 1.88± 0 .2 9)kPa ,明显低于I/R组 (P <0 .0 1) ;④IPC组支气管肺泡灌洗液中总磷脂为 ( 2 33 .42± 14.0 5 ) μg/kg ,大聚体为 ( 10 5 .39± 6 .17) μg/kg ,与I/R组相比显著增高 ,但低于对照组 (P <0 .0 1) ,三组之间小聚体含量没有显著差异 ;⑤IPC组表面张力为 ( 36 .88± 3.49)mN/m ,显著低于I/R组 ,与对照组相比则无显著性差异 (P >0 .0 5 )。结论 :缺血预处理对大鼠肺I/R损伤有保护作用 ,保护机制可能与促进肺表面活性物质 (PS)磷脂分泌、改善PS组成 ,从而提高PS功能有关。     

Role of nitric oxide in liver ischemia and reperfusion injury

The present study was designed to assess the role of endothelial cell and inducible nitric oxide synthase (eNOS, iNOS)-derived NO in ischemia/reperfusion (I/R)-induced pro-inflammatory cytokine expression and tissue injury in a murine model of hepatic I/R. Forty-five min of partial hepatic ischemia and 3 h of reperfusion resulted in a significant increase in liver injury as assessed by serum alanine aminotransferase and histopathology which occurred in the absence of neutrophil infiltration. Both iNOS and eNOS deficient mice exhibited enhanced liver injury when compared to their wild type (wt) controls again in the absence of neutrophil infiltration. Interestingly, message expression for both tumor necrosis factor-alpha (TNF-alpha) and interleukin 12 (IL-12) were enhanced in eNOS, but not iNOS-deficient mice at 1 h post-ischemia when compared to their wt controls. In addition, eNOS message expression appeared to be up-regulated between 1 and 3 h ofreperfusion in wt mice while iNOS deficient mice exhibited substantial increases at I but not 3 h. Taken together, these data demonstrate the ability of eNOS and iNOS to protect the post-ischemic liver, however their mechanisms of action may be very different.     

Role of nitric oxide in liver ischemia and reperfusion injury

The present study was designed to assess the role of endothelial cell and inducible nitric oxide synthase (eNOS, iNOS)-derived NO in ischemia/reperfusion (I/R)-induced pro-inflammatory cytokine expression and tissue injury in a murine model of hepatic I/R. Forty-five min of partial hepatic ischemia and 3 h of reperfusion resulted in a significant increase in liver injury as assessed by serum alanine aminotransferase and histopathology which occurred in the absence of neutrophil infiltration. Both iNOS and eNOS deficient mice exhibited enhanced liver injury when compared to their wild type (wt) controls again in the absence of neutrophil infiltration. Interestingly, message expression for both tumor necrosis factor-alpha (TNF-) and interleukin 12 (IL-12) were enhanced in eNOS, but not iNOS-deficient mice at 1 h post-ischemia when compared to their wt controls. In addition, eNOS message expression appeared to be up-regulated between 1 and 3 h of reperfusion in wt mice while iNOS deficient mice exhibited substantial increases at 1 but not 3 h. Taken together, these data demonstrate the ability of eNOS and iNOS to protect the post-ischemic liver, however their mechanisms of action may be very different.     

Hepatocellular protection by nitric oxide or nitrite in ischemia and reperfusion injury

Ischemia and reperfusion (I/R)-induced liver injury occurs in several pathophysiological disorders including hemorrhagic shock and burn as well as resectional and transplantation surgery. One of the earliest events associated with reperfusion of ischemic liver is endothelial dysfunction characterized by the decreased production of endothelial cell-derived nitric oxide (NO). This rapid post-ischemic decrease in NO bioavailability appears to be due to decreased synthesis of NO, enhanced inactivation of NO by the overproduction of superoxide or both. This review presents the most current evidence supporting the concept that decreased bioavailability of NO concomitant with enhanced production of reactive oxygen species initiates hepatocellular injury and that endogenous NO or exogenous NO produced from nitrite play important roles in limiting post-ischemic tissue injury.     

Preventive role of gallic acid on hepatic ischemia and reperfusion injury in rats

There is little information about the hepatoprotective effects of gallic acid against ischemia–reperfusion (I/R) damage. Animals were subjected to I/R. Gallic acid at doses of 50 and 100 mg/kg body weight (bw) were injected as a single dose prior to ischemia. Liver tissue homogenates were used for the measurement of malondialdehyde (MDA), catalase (CAT) and glutathione peroxidase (GPx) levels. At the same time alanine aminotransferase (ALT), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) were assayed in serum samples and compared statistically. While the ALT, AST, LDH activities and MDA levels were significantly increased, CAT and GPx activities significantly decreased in only I/R-induced control rats compared to normal control rats (P < 0.05). Treatment with gallic acid at a dose of 100 mg/kg bw significantly decreased the ALT, AST, LDH activities and MDA levels, and markedly increased activities of CAT and GPx in tissue homogenates compared to I/R-induced rats with no treatment group (P < 0.05). In oxidative stress generated by hepatic ischemia–reperfusion, gallic acid contributes partially an alteration in the delicate balance between the scavenging capacity of antioxidant defense systems and free radicals in favour of the antioxidant defense systems in the body.     

大鼠心脏缺血-再灌注损伤对心肌L-Arg/NO途径的影响

为探讨大鼠心脏缺血-再灌注损伤(IRI)期间一氧化氮(NO)生成增加的环节和过程。本实验用离体灌流大鼠心脏,预灌流15 min,停灌45 min,取30 ml KH 液循环灌流15 min,观察冠脉流出液中细胞胞浆酶(LDH)、蛋白质、肌红蛋白漏出量和NO     

Myocardial ischemia/reperfusion injury in the inducible nitric oxide synthase knockout mice.

Inducible nitric oxide synthase (iNOS) plays an important role in the inflammatory process of certain major cardiac disorders including myocardial infarction and allograft rejection. However, the role of iNOS in acute myocardial ischemia has not been well defined. We determined the effects of genetically disruption of the intact iNOS system on cardiac tolerance to ischemia/reperfusion injury. Adult male wild-type (WT) and iNOS knockout (KO) B6,129 mice were subjected to 20 min global ischemia and 30 min reperfusion in a Langendorff isolated perfused heart model (37 degrees C, n = 10/each group). Ventricular contractile function, heart rate, coronary flow, and leakage of intracellular enzymes (CK and LDH) were not significantly different between the groups during pre-ischemia as well as reperfusion period (P > 0.05). Myocardial infarct size was also not significantly different between WT (20.2+/-2.0% of risk area) and KO mice (23.5+/-3.8%; Mean+/-SEM, P > 0.05). However, the post-ischemic heart rate was significantly preserved in KO as compared to WT (P < 0.05). We conclude that disruption of iNOS gene does not exacerbate ischemia/ reperfusion injury in the heart.     

Knock out of neuronal nitric oxide synthase exacerbates intestinal ischemia/reperfusion injury in mice

Recent investigation of the intestine following ischemia and reperfusion (I/R) has revealed that nitric oxide synthase (NOS) neurons are more strongly affected than other neuron types. This implies that NO originating from NOS neurons contributes to neuronal damage. However, there is also evidence of the neuroprotective effects of NO. In this study, we compared the effects of I/R on the intestines of neuronal NOS knockout (nNOS(-/-)) mice and wild-type mice. I/R caused histological damage to the mucosa and muscle and infiltration of neutrophils into the external muscle layers. Damage to the mucosa and muscle was more severe and greater infiltration by neutrophils occurred in the first 24?h in nNOS(-/-) mice. Immunohistochemistry for the contractile protein, α-smooth muscle actin, was used to evaluate muscle damage. Smooth muscle actin occurred in the majority of smooth muscle cells in the external musculature of normal mice but was absent from most cells and was reduced in the cytoplasm of other cells following I/R. The loss was greater in nNOS(-/-) mice. Basal contractile activity of the longitudinal muscle and contractile responses to nerve stimulation or a muscarinic agonist were reduced in regions subjected to I/R and the effects were greater in nNOS(-/-) mice. Reductions in responsiveness also occurred in regions of operated mice not subjected to I/R. This is attributed to post-operative ileus that is not significantly affected by knockout of nNOS. The results indicate that deleterious effects are greater in regions subjected to I/R in mice lacking nNOS compared with normal mice, implying that NO produced by nNOS has protective effects that outweigh any damaging effect of this free radical produced by enteric neurons.     

Attenuated nitric oxide synthase activity and protein expression accompany intestinal ischemia/reperfusion injury in rats

Intestinal ischemia/reperfusion (I/R) leads to bowel impairment via the release of reactive oxygen species (ROS) and neutrophil infiltration. In addition to modulating intestinal integrity, nitric oxide (NO(*)) inhibits neutrophil activation and scavenges ROS. Attenuated endogenous NO(*) formation may result in the accrual of these deleterious stimuli. Therefore, we determined nitric oxide synthase (NOS) activity in anesthetized rats subjected to 1 h of superior mesenteric ischemia or ischemia followed by reflow. NOS activity was measured in intestinal tissue homogenates as the conversion rate of (3)H-L-arginine to (3)H-L-citrulline. Our results demonstrate that intestinal ischemia leads to a decrease in NOS activity indicating lower NO(*) formation in the animal model. The attenuation in NOS activity was not reversed following 4 h of reperfusion. Western blot analysis revealed that the decline in enzyme activity was accompanied by reduced intestinal NOS III (endothelial constitutive NOS) expression. These findings provide biochemical evidence for impaired NO(*) formation machinery in intestinal I/R injury.     

Myeloperoxidase enhances nitric oxide catabolism during myocardial ischemia and reperfusion

Impaired microvascular function during myocardial ischemia and reperfusion is associated with recruitment of polymorphonuclear neutrophils (PMN) and has been attributed to decreased bioavailability of nitric oxide (NO). Whereas myeloperoxidase (MPO), a highly abundant, PMN-derived heme protein facilitates oxidative NO consumption and impairs vascular function in animal models of acute inflammation, its capacity to function in this regard during human myocardial ischemia and reperfusion remains unknown. Plasma samples from 30 consecutive patients (61 +/- 14 years, 80% male) presenting with acute myocardial infarction were collected 9 +/- 4 h after vessel recanalization and compared to plasma from healthy control subjects (n = 12). Plasma levels of MPO were higher in patients than in control subjects (1.4 +/- 0.9 vs 0.3 +/- 0.2 ng/mg protein, respectively, p < 0.0001). The addition of hydrogen peroxide to patient plasma resulted in accelerated rates of NO consumption compared to control subjects (0.53 +/- 0.25 vs 0.068 +/- 0.039 nM/s/mg protein, respectively, p < 0.0001). Myocardial tissue from patients with the same pathology revealed intense recruitment of MPO-positive PMN localized along infarct-related vessels as well as diffuse endothelial distribution of non-PMN-associated MPO immunoreactivity. Endothelium-dependent microvascular function, as assessed by an acetylcholine-dependent increase in forearm blood flow in 75 patients with symptomatic coronary artery disease, inversely correlated with MPO plasma levels (r = -0.75, p < 0.005). Plasma from patients undergoing myocardial reperfusion contained increased levels of MPO, which catalytically consumed NO in the presence of H(2)O(2). Given the correlation between intravascular MPO levels and forearm vasomotor function in patients with coronary artery disease, MPO appears to be an important modulator of vasomotor function in inflammatory vascular disease and a potential therapeutic target for treatment.