The timing of propofol administration affects the effectiveness of remote ischemic preconditioning induced cardioprotection in rats

The cardioprotection of remote ischemic preconditioning (RIPC) is abolished under propofol maintained anesthesia. Transient receptor potential vanilloid 1 (TRPV1) channel is present in the heart, and its activation could induce cardioprotection. Therefore, we tested whether the anesthetic propofol administration phase interfered with the RIPC-induced cardioprotection, and RIPC-induced cardioprotection via the cardiac TRPV1 channel. Male Sprague-Dawley rats were subjected to myocardial 30 minutes of ischemia followed by 2 hours of reperfusion. RIPC consisted of three cycles of 5-minute ischemia/reperfusion applied to a hindlimb. Propofol infusion at 12 mg/kg/h was commenced either at 10 minutes before the start of RIPC in the P-pre + RIPC group, or immediately after myocardial ischemia at the onset of reperfusion (P-post + RIPC) while performing RIPC. These two propofol infusion regimes were applied to another two grou bs without RIPC (P-pre and P-post groups). Infarct size (IS) was assessed by triphenyltetrazolium staining. Heart TRPV1 expression was detected by Western blot and immunofluorescence. RIPC significantly reduced myocardial IS compared with the control group (36.7 ± 3% versus 57.2 ± 4%; P < .01). When propofol was started before RIPC, the IS sparing effect of RIPC was completely abolished. However, propofol infusion starting immediately after myocardial ischemia did not affect RIPC-induced cardioprotection. TRPV1 expression significant increase after RIPC, then propofol inhibited the TRPV1 activation of RIPC if given before RIPC but not after. Our results suggest that the timing of propofol administration is critical to preserve the cardioprotection of RIPC. Propofol might cancel RIPC-induced cardioprotection via the cardiac TRPV1 receptor.     

11,12.环氧二十碳三烯酸预处理与后处理对缺血/再灌注大鼠心肌的保护作用

采用Langendorff离体灌流装置,通过停灌40 min/复灌30 min复制大鼠心肌缺血/再灌注(ischemia/reperfusion,IR)损伤模型,观察11,12-环氧二十碳三烯酸(11,12-epoxyeicosatrienoic acid,11,12-EET)预处理和后处理对心肌线粒体功能以及心功能的影响,探讨11,12-EET顸处理和后处理对IR大鼠心肌的作用及其机制.将30只Sprague-Dawley大鼠随机分为对照组、IR组、EET预处理组(Pre-EET)、EET后处理组(Post-EET),每组6只.除对照组外,其它各组全心缺血40 min,再灌注30 min.监测左心室内压差(ALVP)和左心室内压升降的最大变化率(±dp/dtmax)等心功能指标,测定灌流液中乳酸脱氢酶(1actate dehydrogenase,LDH)的活性.灌流结束后,测定心肌线粒体琥珀酸脱氢酶(succinate dehydrogenase,SDH)、Ca"ATPase、Na - K -ATPase活性以及心肌超氧化物歧化酶(superoxide dismutase,SOD)活性、丙二醛(malondialdehyde,MDA)含量.结果显示:(1)与IR组相比,Pre-EET组及Post.EET组Na -K -ATPase和SDH活性均增强,Ca2 -ATPase活性均减弱,有显著性差异(P<0.05);而Pre-EET与Post-EET组间没有显著性差异.(2)与IR组相比,Pre-EET组及Post-EET组心功能明显改善,LDH漏出显著减少,心肌SOD活性明显增强,MDA含量明显降低,有显著性差异(P<0.05);而Pre-EET与Post-EET组间没有显著性差异.结果表明,11,12-EET预处理及后处理均可通过上调心肌线粒体Na -K -ATPase、SDH活性以及下调Ca2 -ATPase活性改善线粒体功能和心肌能量代谢,拮抗心肌IR损伤;11,12-EET预处理及后处理还可通过提高心肌SOD活性、降低MDA含量改善IR心肌的氧化应激.     

Metformin mediates cardioprotection against aging‐induced ischemic necroptosis

Necroptosis is crucially involved in severe cardiac pathological conditions. However, whether necroptosis contributes to age‐related intolerance to ischemia/reperfusion (I/R) injury remains elusive. In addition, metformin as a potential anti‐aging related injury drug, how it interacts with myocardial necroptosis is not yet clear. Male C57BL/6 mice at 3–4‐ (young) and 22–24 months of age (aged) and RIPK3‐deficient (Ripk3^?/?) mice were used to investigate aging‐related I/R injury in vivo. Metformin (125 μg/kg, i.p.), necrostatin‐1 (3.5 mg/kg), and adenovirus vector encoding p62‐shRNAs (Ad‐sh‐p62) were used to treat aging mice. I/R‐induced myocardial necroptosis was exaggerated in aged mice, which correlated with autophagy defects characterized by p62 accumulation in aged hearts or aged human myocardium. Functionally, blocking autophagic flux promoted H/R‐evoked cardiomyocyte necroptosis in vitro. We further revealed that p62 forms a complex with RIP1‐RIP3 (necrosome) and promotes the binding of RIP1 and RIP3. In mice, necrostatin‐1 treatment (a RIP1 inhibitor), RIP3 deficiency, and cardiac p62 knockdown in vivo demonstrated that p62‐RIP1‐RIP3‐dependent myocardial necroptosis contributes to aging‐related myocardial vulnerability to I/R injury. Notably, metformin treatment disrupted p62‐RIP1‐RIP3 complexes and effectively repressed I/R‐induced necroptosis in aged hearts, ultimately reducing mortality in this model. These findings highlight previously unknown mechanisms of aging‐related myocardial ischemic vulnerability: p62‐necrosome‐dependent necroptosis. Metformin acts as a cardioprotective agent that inhibits this unfavorable chain mechanism of aging‐related I/R susceptibility.     

Diabetic animal fed with high‐fat diet prevents the protective effect of myocardial ischemic preconditioning effect in isolated rat heart perfusion model

Diabetic heart (diabetes mellitus [DM]) has been shown to attenuate the beneficial effect of ischemic preconditioning (IPC) in rat heart. But the effect of IPC on diabetic rat heart that develops myopathy remains unclear. This study was designed to test the impact of IPC on diabetic cardiomyopathy (DCM) rat heart. Male Wistar rats were grouped as (a) normal, (b) DM (streptozotocin: 65 mg/kg; fed with normal diet), and (c) DCM (streptozotocin: 65 mg/kg; fed with high‐fat diet). Isolated rat hearts from each group were randomly subjected to (a) normal perfusion, (b) ischemia‐reperfusion (I/R), and (c) IPC procedure. At the end of the perfusion experiments, hearts were analyzed for injury, contractile function, mitochondrial activity, and oxidative stress. The results obtained from hemodynamics, cardiac injury markers, and caspase‐3 activity showed that DCM rat displayed prominent I/R‐associated cardiac abnormalities than DM rat heart. But the deteriorated physiological performance and cardiac injury were not recovered in both DM and DCM heart by IPC procedure. Unlike normal rat heart, IPC did not reverse mitochondrial dysfunction (determined by electron transport chain enzymes activity, ATP level, and membrane integrity, expression levels of genes like PGC‐1ɑ, GSK3β, complex I, II, and V) in DCM and DM rat heart. The present study demonstrated that IPC failed to protect I/R‐challenged DCM rat heart, and the underlying pathology was associated with deteriorated mitochondrial function.     

Lysophospholipid receptor-dependent and -independent calcium signaling

Changes in cellular Ca(2+) concentrations form a ubiquitous signal regulating numerous processes such as fertilization, differentiation, proliferation, contraction, and secretion. The Ca(2+) signal, highly organized in space and time, is generated by the cellular Ca(2+) signaling toolkit. Lysophospholipids, such as sphingosine-1-phosphate (S1P), sphingosylphosphorylcholine (SPC), or lysophosphatidic acid (LPA) use this toolkit in a specific manner to initiate their cellular responses. Acting as agonists at G protein-coupled receptors, S1P, SPC, and LPA increase the intracellular free Ca(2+) concentration ([Ca(2+)](i)) by using the classical, phospholipase C (PLC)-dependent pathway as well as PLC-independent pathways such as sphingosine kinase (SphK)/S1P. The S1P(1) receptor, via protein kinase C, inhibits the [Ca(2+)](i) transients caused by other receptors. Both S1P and SPC also act intracellularly to regulate [Ca(2+)](i). Intracellular S1P mobilizes Ca(2+) in intact cells independently of G protein-coupled S1P receptors, and Ca(2+) signaling by many agonists requires SphK-mediated S1P production. As shown for the FcepsilonRI receptor, PLC and SphK may contribute specific components to the overall [Ca(2+)](i) transient. Of the many open questions, identification of the intracellular S1P target site(s) appears to be of particular importance.     

血红素氧合酶-1在离体大鼠心肌缺血预适应中的作用

目的:分别观察给予HO-1诱导剂和抑制剂对心肌相对缺血再灌注损伤和缺血预适应的影响,探讨HO-1在缺血预适应中的作用.方法:实验动物随机分为对照组(CN)、缺血/再灌损伤组(I/R)、缺血预适应 缺血/再灌损伤组(PC)、HO-1诱导剂 缺血/再灌损伤组(HM)、HO-1抑制剂 缺血预适应组(ZP).心肌缺血/再灌损伤采用相对缺血/再灌损伤模型,缺血预适应则为相对缺血5min恢复5min,反复2次.测定心功能、MDA及HO-1活性变化.结果:HM组HO-1活性升高,心功能恢复率均显著高于IR组(P＜0.01),MDA含量显著低于IR组(P＜0.05).ZP组活性降低,心功能恢复率显著低于PC组(P＜0.05),MDA含量显著高于PC组(P＜0 05).结论:HO-1是缺血预适应释放的内源性活性物质之一.     

Klotho protein contributes to cardioprotection during ischaemia/reperfusion injury

Restoration of blood flow to ischaemic heart inflicts ischaemia/reperfusion (I/R) injury, which manifests in metabolic and morphological disorders. Klotho is a protein with antioxidative and antiapoptotic activity, and is involved in the regulation of inflammation and fibrosis. The aim of the current research was to determine the role of Klotho in the heart subjected to I/R injury, as well as to study Klotho as a potential cardioprotective agent. Human cardiomyocytes and Wistar rat hearts perfused using Langendorff method subjected to I/R have been used. Hemodynamic parameters of heart function, markers of I/R injury, and gene and protein expression of Klotho were measured. Human cardiomyocytes were also incubated in the presence of recombinant Klotho protein, and the viability of cells was measured. There was a higher expression of Klotho gene and protein synthesis in the cardiomyocytes subjected to I/R injury. The compensatory production and release of Klotho protein from cardiac tissue during I/R were also shown. The treatment of cardiomyocytes subjected to I/R with Klotho protein resulted in increased viability and metabolic activity of cells. Thus, Klotho contributes to compensatory mechanism during I/R, and could be used as a marker of injury and as a potential cardiopreventive/cardioprotective agent.     

Targeting mitochondrial fusion and fission proteins for cardioprotection

New treatments are needed to protect the myocardium against the detrimental effects of acute ischaemia/reperfusion (IR) injury following an acute myocardial infarction (AMI), in order to limit myocardial infarct (MI) size, preserve cardiac function and prevent the onset of heart failure (HF). Given the critical role of mitochondria in energy production for cardiac contractile function, prevention of mitochondrial dysfunction during acute myocardial IRI may provide novel cardioprotective strategies. In this regard, the mitochondrial fusion and fissions proteins, which regulate changes in mitochondrial morphology, are known to impact on mitochondrial quality control by modulating mitochondrial biogenesis, mitophagy and the mitochondrial unfolded protein response. In this article, we review how targeting these inter‐related processes may provide novel treatment targets and new therapeutic strategies for reducing MI size, preventing the onset of HF following AMI.     

Ischemic preconditioning in isolated perfused mouse heart: Reduction in infarct size without improvement of post-ischemic ventricular function

Genetically engineered mice provide an excellent tool to study the role of a particular gene in biological systems and will be increasingly used as models to understand the signal transduction mechanisms involved in ischemic preconditioning (IP). However, the phenomenon of IP has not been well characterized in this species. We therefore attempted to examine whether IP could protect isolated mouse heart against global ischemia/reperfusion (GI/R) injury. Thirty adult mice hearts were perfused at constant pressure of 55 mmHg in Langendorff mode. Following 20 min equilibration, the hearts were randomized into three groups (n = 10/each): (1) Control Group; (2) IP2.5 Group: IP with two cycles of 2.5 min GI + 2.5 min R; (3) IP5 Group: IP with 5 min GI + 5 min R. All hearts were then subjected to 20 min of GI and 30 min R (37°C). Ventricular developed force was measured by a force transducer attached to the apex. Leakage of CK and LDH was measured in coronary efflux. Infarct size was determined by tetrazolium staining. Following sustained GI/R, infarct size was significantly reduced in IP2.5 (13.8 ± 2.3%), but not in IP5 (20.1 ± 4.0%), when compared with non-preconditioned control (23.6 ± 3.8%) hearts. CK and LDH release was also reduced in both IP2.5 and IP5 groups. No significant improvement in post-ischemic ventricular contractile function was observed in either IP groups. We conclude that IP with repetitive cycles of brief GI/R is able to reduce myocardial infarct size and intracellular enzyme leakage caused by a sustained GI/R in the isolated perfused mouse heart. This anti-necrosis cardioprotection induced by IP was not associated with the amelioration of post-ischemic ventricular dysfunction.     

Mitochondrial ion channels as targets for cardioprotection

Acute myocardial infarction (AMI) and the heart failure (HF) that often result remain the leading causes of death and disability worldwide. As such, new therapeutic targets need to be discovered to protect the myocardium against acute ischaemia/reperfusion (I/R) injury in order to reduce myocardial infarct (MI) size, preserve left ventricular function and prevent the onset of HF. Mitochondrial dysfunction during acute I/R injury is a critical determinant of cell death following AMI, and therefore, ion channels in the inner mitochondrial membrane, which are known to influence cell death and survival, provide potential therapeutic targets for cardioprotection. In this article, we review the role of mitochondrial ion channels, which are known to modulate susceptibility to acute myocardial I/R injury, and we explore their potential roles as therapeutic targets for reducing MI size and preventing HF following AMI.     

雷米普利对糖尿病大鼠心肌缺血／再灌注损伤保护作用的超微结构研究

目的：研究雷米普利对糖尿病大鼠心肌缺血／再灌注损伤的保护作用,并从超微结构的角度初步探讨其作用机制。方法：链脲佐菌素致糖尿病大鼠被随机分为3组（n=16）：缺血／再灌注（I／R）、缺血预适应（IPC）和雷米普利（RAM）组。RAM组每天用雷米普利（1mg／kg）灌胃,I／R和IPC组用等体积生理盐水灌胃。4周后各组动物均经历心肌缺血／再灌注损伤,IPC组于缺血前行心肌缺血预适应。连续监测心电图变化,测定心肌梗死面积,光、电镜下观察心肌形态学改变。结果：与I／R组比较,RAM及IPC组缺血期心脏ST-段抬高幅度降低,室早出现时间推迟,持续时间缩短,室速、室颤发生率降低,心肌梗死面积缩小,形态学观察心肌损伤减轻,心肌纤维及线粒体特征性结构保持清晰,血管通畅,内皮损伤减轻。结论：连续4周使用RAM对实验性糖尿病大鼠具有与IPC相似的心脏保护效应,机制可能与保护心肌细胞及线粒体、改善内皮功能等有关。     

缺血预处理对肢体缺血/再灌注时肺损伤的保护作用

目的：观察肢体缺血/再灌注（LI/R）时肺损伤的变化并探讨缺血预处理（IPC）对其保护作用。方法：复制家兔LI/R损伤模型,观察肢体缺血4 h再灌注4 h肺损伤的变化以及采用肢体IPC干预后对肺损伤的影响。从右颈外静脉和左颈总动脉采血,分别代表入肺血和出肺血,检测入、出肺血及肺组织超氧化物歧化酶（SOD）的活性、脂质过氧化物的代谢产物丙二醛（MDA）和一氧化氮（NO）的含量;同时测定肺组织总一氧化氮合酶（tNOS）和诱导型一氧化氮合酶（iNOS）的活性以及肢体IPC对上述指标的影响。结果：与对照组和缺血前比较,LI/R组松夹再灌注4 h入、出肺血及肺组织SOD活性明显降低,MDA和NO含量增高（P〈0.05,P〈0.01）;肺组织tNOS和iNOS活性亦升高,与对照组比较,有统计学意义（P〈0.01）。在缺血前给予IPC组,SOD活性升高,而MDA、NO含量降低,tNOS、iNOS活性也降低（P〈0.01）。相关分析显示MDA与SOD间存在明显负相关（P〈0.01）,而MDA与NO及iNOS呈显著正相关（P〈0.01）。结论：LI/R时并发的急性肺损伤与组织氧化代谢紊乱有关,IPC通过改善LI/R时肺组织氧化与抗氧化之间的平衡,进而增强肺组织的抗氧化能力,对LI/R肺损伤具有保护作用。     

一氧化氮在乙醇后处理心肌保护中的作用

目的:探讨乙醇后处理心肌保护作用是否与一氧化氮生成有关。方法:局部结扎冠状动脉左前降支30min,复灌120 min复制离体大鼠心肌缺血/复灌模型。心肌缺血末5 min,复灌初期10min给予乙醇50mmol/L,共灌流15 min进行乙醇后处理干预。实验随机分为五组,正常组,缺血/复灌组,乙醇后处理组,乙醇后处理+L-NAME组和乙醇后处理+苍术苷组。测定心室动力学指标和复灌期间冠脉流出液中乳酸脱氢酶(LDH)含量,TTC染色法测定心肌梗死面积,硝酸还原法测定心肌组织一氧化氮(NO)含量。RT-PCR检测左心室前壁心尖组织Bc-l2和BaxmRNA的表达。结果:与单纯缺血/复灌相比,乙醇后处理明显促进了左室发展压、左室做功的恢复,降低复灌期冠脉流出液中LDH的释放和心肌梗死面积,心肌组织NO释放减少,Bc-l 2/Bax mRNA比值增高。一氧化氮合酶抑制剂L-NAME和线粒体渗透性转换孔道开放剂苍术苷均抑制了乙醇后处理心室功能的恢复、LDH释放的减少和梗死面积的降低,心肌组织NO释放进一步减少,Bc-l 2/Bax mRNA比值降低。结论:乙醇后处理的心肌保护作用可能与减少NO的释放、抑制线粒体渗透性转换孔道的开放和抑制细胞凋亡的发生有关。     

血红素氧合酶-1参与心肌细胞延迟预适应

目的:探讨血红素氧合酶-1(HO-1)在心肌细胞缺血预适应(IPC)中的作用。方法:实验分5组:正常对照组(CN组)、缺血/再灌注组(I/R组)、缺血预适应+缺血/再灌注组(PC组)、ZnPP(HO-1抑制剂)+缺血预适应+缺血/再灌注组(ZP组)和Hemin(HO-1诱导剂)+缺血/再灌注组(HE组)。测定HO-1mRNA表达、心肌细胞存活率、胞内[Ca2+]i和细胞培养液中MDA含量等。结果:PC组和HE组HO-1mRNA表达量和细胞存活率显著高于I/R组,而MDA含量和胞内[Ca2+]i则皆显著低于I/R组,PC组各指标与ZP组间有显著性差异,与HE组66较未见显著性差异。结论:IPC可以诱导HO-1mRNA表达,对心肌细胞缺血/再灌注损伤产生延迟保护作用。     

Metabolic pathways and physiological and pathological significances of lysolipid phosphate mediators

Lysophosphatidic acid and sphingosine 1-phosphate are structurally simple and physiologically very important lysophospholipids. Because they possess distinct structural backbones (glycerol and sphingosine, respectively), there are different metabolic pathways for their intracellular production. Recently, several key enzymes that produce or degrade these lysolipid phosphate mediators extracellularly have been characterized. This review focuses on the physiological and pathophysiological significances of the extracellular metabolic pathways involving recently characterized exo-type lysophospholipase D, ecto-type phospholipase A, and ecto-type lipid phosphate phosphatase.     

Inhibition of cathepsin S attenuates myocardial ischemia/reperfusion injury by suppressing inflammation and apoptosis

Myocardial ischemia/reperfusion (I/R) injury leads to high mortality and morbidity due to the incomplete understanding of the underlying mechanism and the consequent lack of effective therapy. The present study revealed and validated key candidate genes in relation to inflammation and apoptosis pathways underlying myocardial I/R injury. Cathepsin S was identified as the top hub protein based on the protein–protein interaction analysis, and, thus, its role during myocardial I/R injury was further investigated. Myocardial I/R in mice resulted in significantly increased levels of myocardial injury biomarkers (cardiac troponin I, lactic dehydrogenase, and creatinine kinase‐MB) and inflammatory cytokines (interleukin‐1β [IL‐1β], IL‐6, and tumor necrosis factor‐α), elevated apoptosis rate, and upregulated protein expression of cleaved caspase‐8, cleaved caspase‐3, and cleaved poly ADP‐ribose polymerase. These abovementioned changes were blocked by two different selective cathepsin S inhibitors, LY3000328 or MIV‐247. Moreover, Kaplan–Meier survival plot showed that cathepsin S inhibition improved 21‐day survival rate following myocardial I/R injury. This study demonstrated that the inhibition of cathepsin S alleviated myocardial I/R‐induced injury by suppressing inflammation and apoptosis, which may be used in clinical applications of cardioprotection.     

Novel clusters of receptors for sphingosine-1-phosphate, sphingosylphosphorylcholine, and (lyso)-phosphatidic acid: new receptors for "old" ligands

The (lyso)phospholipid mediators sphingosine-1-phosphate (S1P), lysophosphatidic acid (LPA), sphingosylphosphorylcholine (SPC), and phosphatidic acid (PA) regulate diverse cellular responses such as proliferation, survival and death, cytoskeletal rearrangements, cell motility, and differentiation among many others. Signaling is complex and many signaling events are mediated through the activation of cell surface seven transmembrane (7TM) G protein coupled receptors. Five high affinity receptors for S1P have been identified so far and named S1P(1, 2,3,4,5) (formerly referred to as endothelial differentiation gene (edg)1, 5, 3, 6, 8). Recently, the orphan receptor GPR63 was identified a low affinity S1P receptor structurally distant from the S1P(1-5) family. The orphan GPR3, 6, 12 cluster, phylogenetically related to the edg and melanocortin receptors appears to be subject to modulation by S1P and SPC although all three receptors are strong constitutive stimulators of the Galphas-adenylyl cyclase (AC) pathway and would not require additional ligand stimulation but rather inverse agonism to control activity. Ovarian cancer G protein coupled receptor 1 (OGR1) and GPR4, two structurally closely related receptors were assigned in functional and binding studies as high affinity molecular targets for SPC. Very recently, however, both OGR1 and GPR4 were described as receptors endowed with the ability to signal cells in response to protons. LPA exerts its biological effects through the activation of G protein coupled LPA(1-3) receptors (formerly referred to as edg2, 4, 7). A fourth high affinity LPA receptor has been identified: P2Y9 (GPR23) structurally related to nucleotide receptors and phylogenetically quite distant from the high affinity LPA(1-3) cluster. This review attempts to give an overview about the existing families of lysophosholipid receptors and the spectrum of lipid agonists they use as high or low affinity ligands to relay extracellular signals into intracellular responses. Recently deorphaned lipid receptors, within and outside the known lipid receptor clusters will receive particular attention.     

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。