全脑缺血预处理诱导大鼠海马缺血耐受的实验研究

目的和方法：采用大鼠四血管闭塞全脑缺血模型（4－vessel occlusion,4VO）及组织病理学方法,观察预缺血的持续时间,和预缺血与其后的损伤性缺血之间的间隔时间对海马缺血耐受形成的影响。结果：缺血6min即可导致海马组织明显的神经元延迟性死亡（delayed neuron death,DND),而缺血3min不足以引起海马组织明显的DND。经过3min缺血预处理,可对间隔1d和3d后6min缺血引起的大鼠海马DND产生明显的保护作用（P＜0．01）。但是,1min缺血预处理对间隔1d后6min缺血引起的DND不产生明显影响;5min缺血预处理时间隔1d后6min缺血,以及3min缺血预处理对间隔1h后6min缺血引起的DND不但没有保护作用,反而有使海马组织损伤累积加重的趋势。结论：在4VO大鼠模型中,全脑缺血预处理确能诱导海马对缺血性损伤产生耐受,诱导海马缺血耐受所需缺血预处理的适宜期间为3min左右,预缺血与后续损伤性缺血之间需要间隔足够的时间,适宜间隔在1－3d左右。     

后肢远程缺血预处理对小鼠全脑缺血再灌注的保护作用及机理

目的:探讨肢端远程缺血预处理(limb remote ischemic preconditioning)对小鼠全脑缺血再灌注损伤的保护作用及其机制.方法:36只雄性C57小鼠,随机分为3组,即假手术组、对照组和LRPC预处理组,每组12只,假手术组分离双侧颈总动脉不结扎;对照组分离颈总动脉后结扎双侧颈总动脉,20 min后松线;LRPC组首先暴露双侧股动脉,然后结扎1 min,松开5 min,进行3个循环,最后结扎颈总动脉20min后松线.观察和比较各组小鼠海马神经元形态,MPO及炎性因子IL-1β、TNF-α和IL-10含量的变化.结果:再灌注24 h后,LRPC可明显抑制神经元形态的改变(P＜0.05),减少MPO、IL-1β和TNF-α含量,而增加抗炎因子IL-10的含量.结论:LRPC可显著减轻脑缺血再灌注损伤,可能与其降低海马组织TNF-o,IL-1β的含量,增加IL-10的含量有关.     

缺血预处理对缺血再灌注后兔脊髓磷酸腺苷代谢的影响

目的：研究缺血参处理对缺血再灌注后兔脊髓磷酸腺苷代谢的影响。方法：往置入腹主动脉的Swan-Ganz导管气囊内注气造成兔腰髓缺血模型。将实验兔分为假手术组、缺血组和预处理组。应用反相高效液相色谱方法（reverse phase HPLC),对缺血再灌注后不同时间点腰髓组织中磷酸腺苷（ATP、ADP、AMP）的含量进行检测。结果：和假手术组相比,缺血组兔再灌后各时间点腰髓组织ATP含量有明显下降（P＜0．01）。与缺血组相应时间点相比,预处理组兔再灌注后腰髓组织ATP含量明显提高（P＜0．01）。结论：缺血预处理显著提高缺血再灌注后兔脊髓组织ATP含量,这可能是缺血预处理对脊髓缺血再灌注损伤产生保护作用的机制之一。     

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。     

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。     

p38 MAPK反义寡聚脱氧核苷酸阻断肢体缺血预处理诱导的脑缺血耐受

目的:观察p38MAPK反义寡聚脱氧核苷酸(As-ODN)对肢体缺血预处理(LIP)诱导的脑缺血耐受的影响。方法:48只永久凝闭双侧椎动脉的Wistar大鼠分为8组(n=6):sham组、LIP组、脑缺血损伤组、LIP+脑缺血损伤组、双蒸水+LIP+脑缺血损伤组、p38MAPKAs-ODN组和p38MAPKAs-ODN+LIP+脑缺血损伤组,p38MAPKAs-ODN的剂量又分为5nmol/5μl和10nmol/5μl。所有动物均在sham手术后或末次全脑缺血/再灌注后7天断头取脑,硫堇染色观察海马CA1区锥体神经元迟发性死亡情况。结果:sham组和LIP组均未见延迟性神经元死亡(DND)。与sham、LIP组相比,脑缺血损伤组出现了明显的DND,表现为组织学分级(HG)升高和锥体神经元密度(ND)下降(P0.05)。LIP可显著抑制脑缺血损伤引起的DND。与LIP+脑缺血损伤组相比,p38MAPKAs-ODN+LIP+脑缺血损伤组出现了显著的DND,表现为HG升高、ND降低(P0.05),且此种变化与p38MAPKAs-ODN的注射剂量呈明显正相关。结论:p38MAPKAs-ODN可阻断LIP诱导的脑缺血耐受,进一步证实了p38MAPK表达上调参与了LIP诱导的脑缺血耐受。     

缺血预处理对肢体缺血/再灌注大鼠胃粘膜损伤的保护效应

目的：观察肢体缺血再灌注（LI／R）对胃粘膜的损伤作用及缺血预处理对其影响,探讨胃粘膜损伤的机制及缺血预处理（IPC）的作用机理。方法：观察并测定肢体缺血4h再灌注4h后以及应用肢体缺血预处理干预后各组胃粘膜损伤指数,胃结合粘液量;检测胃粘膜中髓过氧化物酶（MPO）、超氧化物歧化酶（SOD）、丙二醛（MDA）、黄嘌呤氧化酶（XOD）含量的变化以及血浆中乳酸脱氢酶（LDH）的含量变化。结果：大鼠LI／R后胃粘膜损伤指数增加;胃结合粘液量较对照组显著下降;胃粘膜中MPO、MDA、XOD的值均较对照组增加,血浆中LDH的含量亦较对照组显著增加,胃粘膜组织中SOD的酶活力下降;IPC组与LIR组对比,胃结合粘液量较LIR组显著增加：胃粘膜损伤指数、胃粘膜中MPO的含量、以及胃粘膜中MDA、XOD、LDH均较LI／R组明显降低;胃粘膜中SOD酶活力增强。结论：LI／R作为应激原可引起胃粘膜损伤,导致应激性溃疡的发生;自由基在肢体缺血再／灌注后继发胃粘膜损伤过程中发挥作用。缺血预处理可减轻肢体缺血再灌注后的胃粘膜损伤,其作用机制可能是通过减少自由基的产生而发挥其保护作用。     

肢体缺血预处理减轻大鼠海马缺血/再灌注损伤

目的:探讨肢体缺血预处理(LIP)对大鼠全脑缺血/再灌注损伤的影响.方法: 36只大鼠椎动脉凝闭后随机分为假手术(Control)组、脑缺血组、肢体缺血组、LIP 0 d组(LIP后即刻行脑缺血)、LIP 1 d组(LIP后1 d行脑缺血)和LIP 2 d组(LIP后2 d行脑缺血).重复夹闭大鼠双侧股动脉3次(每次10 min,间隔10 min)作为LIP,夹闭颈总动脉进行全脑缺血8 min后再灌注.硫堇染色观察海马CA1区组织学分级及锥体神经元密度以判断海马损伤程度.结果:脑缺血组海马CA1区锥体神经元损伤严重,与Control组比较,组织学分级明显升高,神经元密度明显降低(P<0.01).LIP 0 d组海马CA1区神经元损伤较脑缺血组明显减轻,组织学分级明显降低,神经元密度明显升高(P<0.01).而LIP 1 d组和LIP 2 d组大鼠海马CA1区锥体细胞缺失较多,仍有明显的组织损伤.结论:LIP可减轻随后立即发生的脑缺血/再灌注损伤,但对间隔1 d后的脑缺血/再灌注损伤无显著对抗作用.     

远端缺血预处理对同种异体肾移植术后患者肾功能的影响

目的:探讨远端缺血预处理对同种异体肾移植术后患者肾功能的影响。方法:选择行同种异体肾移植手术的患者20例,并将其随机分为实验组(S)和对照组(D),每组10例。S组于麻醉后在左下肢绑扎止血带行远端缺血预处理,D组不作缺血预处理。分别于术前(T0)、术后24(T1)、48(T2)、72h(T3)记录患者的尿量;生化检测患者血清尿素氮(BUN)和肌酐(Scr)含量;ELISA检测患者肾损伤分子-1(Kim-1)的含量。结果:两组患者的一般情况比较无统计学差异(P0.05)。两组患者术后各时点的尿量均较术前显著增加,且S组术后各时点的尿量均明显多于D组增多(P0.05)。两组患者术后各时点的Scr、BUN含量均较术前下降,两组T1、T2时点的Scr、BUN含量比较差异无统计学意义(P0.05),但S组术后T3时点血清Scr、BUN水平均明显低于D组(P0.05)。两组患者术后尿液Kim-1水平均较术前明显下降,S组在T3时点的Kim-1水平显著低于D组(P0.05)。结论:远端缺血预处理可显著减轻移植肾缺血再灌注损伤,有利于同种异体肾移植患者术后肾功能的恢复。     

肢体远程预处理通过上调机体抗氧化酶活性诱导兔脊髓缺血耐受

目的:证实抗氧化酶活性上调是肢体远程预处理(remote preconditioning,RPC)诱导兔脊髓缺血耐受效应的主要机制之一。方法:60只雄性新西兰大白兔随机分成对照组、远程预处理组、缺血组及RPC 缺血组(对照组n=6,余组n=18)。RPC组行双下肢短暂缺血2次(每次10min,间隔10min);缺血组仅行脊髓缺血模型;RPC 缺血组在远程预处理后1h行脊髓缺血;对照组为假手术组。对照组于脊髓缺血再灌注后48h行神经功能评分后取脊髓,作为对照。余三组分别于再灌注后6h、24h及48h评分后取材,各时间点各取6只。所有动物于缺血前、缺血20min、再灌注20min及再灌注6h采动脉血测血清抗氧化酶活性和丙二醛(MDA)含量;于取材后测定脊髓匀浆抗氧化酶活性和MDA含量。结果:再灌注后6h、24h及48h时对照组、远程预处理组及远程预处理 缺血组神经功能评分均明显高于缺血组(P<0.05)。血浆超氧化物歧化酶(SOD)活性和过氧化氢酶(CAT)活性在每个时间点RPC组均高于对照组,RPC 缺血组高于缺血组(P<0.05);其中缺血20min时,缺血组血浆SOD、CAT活性低于对照组,RPC 缺血组低于RPC组(P<0.05);而与缺血前相比,缺血20min时缺血组及RPC 缺血组SOD和CAT活性显著下降(P<0.05)再灌注24h和48h时,脊髓匀浆SOD、CAT活性对照组低于RPC组,缺血组低于RPC 缺血组(P<0.01);而MDA含量再灌注24h时对照组高于RPC组,缺血组高于RPC 缺血组(P<0.05)。脊髓匀浆SOD、CAT活性与神经功能评分具有显著相关性。结论:RPC诱导脊髓缺血耐受的机制可能为上调抗氧化酶活性,增强机体在缺血再灌注过程中清除氧自由基的能力,从而减少氧自由基介导的损伤,发挥脊髓保护作用。     

The Role of Nitric Oxide in the Neuroprotection of Limb Ischemic Preconditioning in Rats

Brief limb ischemia was reported to protect neurons against injury induced by subsequent cerebral ischemia-reperfusion, and this phenomenon is known as limb ischemic preconditioning (LIP). To explore the role of nitric oxide (NO) in neuroprotection of LIP in rats, we observed changes in the content of nitric oxide (NO) and activity of NO synthase (NOS) in the serum and CA1 hippocampus of rats after transient limb ischemic preconditioning (LIP), and the influence of N^G-nitro-l-arginine methylester (l-NAME), a NOS inhibitor, on the neuroprotection of LIP against cerebral ischemia-reperfusion injury. Results showed that NO content and NOS activity in serum increased significantly after LIP compared with the sham group. The increase showed a double peak pattern, in which the first one appeared at time 0 (immediate time point) and the second one appeared at 48 h after the LIP (P < 0.01). The NO content and NOS activity in the CA1 hippocampus in LIP group showed similar change pattern with the changes in the serum, except for the first peak of up-regulation of NO content and NOS activity appeared at 6 h after LIP. Pretreatment with l-NAME before LIP blocked the neuroprotection of LIP against subsequent cerebral ischemic insult. The blocking effect of l-NAME was abolished with pretreatment of l-Arg. These findings indicated that NO may be associated with the tolerance of pyramidal cells in the CA1 hippocampus to ischemia induced by LIP in rats.     

高压氧预处理对大鼠局灶性脑缺血再灌注损伤的保护作用

目的:研究高压氧预处理对大鼠脑缺血再灌注损伤的保护作用。方法:36只SD大鼠随机分为假手术组、模型组及高压氧预处理组,每组12只。高压氧预处理组大鼠在造模前5天给予高压氧预处理。采用线栓法建立大鼠脑缺血再灌注模型,观察高压氧预处理对脑缺血再灌注损伤大鼠神经功能缺损评分、脑梗死面积的影响,检测大鼠缺血脑组织COX-2 mRNA和蛋白的表达以及IL-1β、TNF-α、MDA的含量。结果:高压氧预处理可明显改善脑缺血再灌注大鼠神经功能缺损评分,减少脑梗死面积,降低COX-2m RNA和蛋白表达量,抑制IL-1β、TNF-α的表达,降低MDA水平。结论:高压氧预处理对大鼠脑缺血再灌注损伤具有明显的保护作用,其机制可能与抑制IL-1β、TNF-α、COX-2的表达以及减弱脂质过氧化反应有关。     

小檗碱对缺血性脑梗死大鼠氧化应激/炎症反应、血管生成的作用研究

摘要 目的：探讨小檗碱对缺血性脑梗死大鼠氧化应激/炎症反应、血管生成的作用。方法：选取60只SPF级SD大鼠,随机分为对照组、模型组和小檗碱组各20只。建立大鼠脑缺血再灌注损伤模型。术后及给药后7d采用Longa标准评分评估大鼠神经功能。检测各组大鼠脑组织的抗氧化活性和炎症因子水平。采用免疫组化检测脑缺血再灌注皮质微血管密度（MVD）。采用实时定量聚合酶链反应（qRT-PCR）检测低氧诱导生长因子- 1 （HIF-1 ）和血管内皮生长因子（VEGF） mRNA表达水平。采用蛋白免疫印迹试验检测VEGF和HIF-1 蛋白表达水平。结果：模型组和小檗碱组大鼠术后具有神经功能缺损症状表现,Longa评分均高于对照组。给药7 d后,模型组和小檗碱组大鼠Longa评分均高于对照组（P＜0.05）,且小檗碱组大鼠Longa评分低于模型组（P＜0.05）。与对照组比较,模型组丙二醛（MDA）水平显著升高,而谷胱甘肽过氧化物酶（GSH-Px）和超氧化物岐化酶（SOD）活性显著降低（P＜0.05）。与模型组比较,小檗碱组MDA水平显著降低,而GSH-Px和SOD活性显著升高（P＜0.05）。与对照组比较,模型组白细胞介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α）水平显著升高（P＜0.05）。与模型组比较,小檗碱组IL-1β、TNF-α水平显著降低,差异有统计学意义（P＜0.05）。给药7 d后,模型组和小檗碱组MVD、VEGF mRNA和HIF-1 mRNA表达水平均高于对照组（P＜0.05）,而小檗碱组MVD、VEGF mRNA和HIF-1 mRNA表达水平高于模型组（P＜0.05）。给药7 d后,小檗碱组和模型组VEGF和HIF-1 蛋白表达水平均高于对照组（P＜0.05）,而小檗碱组VEGF和HIF-1 蛋白表达水平高于模型组（P＜0.05）。结论：小檗碱通过抑制氧化应激/炎症反应、促进血管生成从而达到脑保护作用,其机制可能与激活HIF-1 /VEGF信号通路有关。     

Neuroprotective Effects of Ischemic Preconditioning in Brain Mitochondria Following Cerebral Ischemia

Numerous studies support the hypothesis that reperfusion following cerebral ischemia contributes substantially to ischemic injury and that mitochondrial dysfunction plays a central role. Defining the mechanisms by which mitochondrial dysfunction occurs may be important for the development of new therapies against delayed neuronal cell death. Ischemic preconditioning (IP) increases an organ's resistance to ischemic injury. There are two windows for IPC, one that requires several hours to develop and another one with a rapid setting (rapid window). However, the rapid window only provides neuroprotection for few days. We have recently determined that this lack of chronic protection by the rapid window was due to lack of protection against mitochondrial dysfunction.     

Effect of Ischemic Preconditioning on Mitochondrial Dysfunction and Mitochondrial P53 Translocation after Transient Global Cerebral Ischemia in Rats

Transient global brain ischemia induces dysfunctions of mitochondria including disturbance in mitochondrial protein synthesis and inhibition of respiratory chain complexes. Due to capacity of mitochondria to release apoptogenic proteins, ischemia-induced mitochondrial dysfunction is considered to be a key event coupling cerebral blood flow arrest to neuronal cell death. Ischemic preconditioning (IPC) represents an important phenomenon of adaptation of central nervous system (CNS) to sub-lethal short-term ischemia, which results in increased tolerance of CNS to the lethal ischemia. In this study we have determined the effect of ischemic preconditioning on ischemia/reperfusion-associated inhibition of mitochondrial protein synthesis and activity of mitochondrial respiratory chain complexes I and IV in the hippocampus of rats. Global brain ischemia was induced by 4-vessel occlusion in duration of 15 min. Rats were preconditioned by 5 min of sub-lethal ischemia and 2 days later, 15 min of lethal ischemia was induced. Our results showed that IPC affects ischemia-induced dysfunction of hippocampal mitochondria in two different ways. Repression of mitochondrial translation induced during reperfusion of the ischemic brain is significantly attenuated by IPC. Slight protective effect of IPC was documented for complex IV, but not for complex I. Despite this, protective effect of IPC on ischemia/reperfusion-associated changes in integrity of mitochondrial membrane and membrane proteins were observed. Since IPC exhibited also inhibitory effect on translocation of p53 to mitochondria, our results indicate that IPC affects downstream processes connecting mitochondrial dysfunction to neuronal cell death.     

神经调节素对大鼠脑缺血再灌注损伤后炎症反应的抑制作用和机制研究

目的：研究神经调节素及基质金属蛋白酶-9对于小鼠大脑缺血再灌注损伤后炎症反应的抑制作用和机制。方法：选取100只成年雄性大鼠,随机分成对照和治疗组。采用线栓方法由颈内到颈外进行插线处理,造成大脑中动脉处于闭塞状态的再灌注动物模型。治疗组颈动脉进行注射少量NRG-1β干预性治疗,通过氯化三苯基四氮唑（TTC）检查脑梗塞范围,细胞凋亡采用原住脱氧核糖核苷酸末端转移酶介导缺口末端进行标记,采用免疫组织化学、免疫荧光双标记法及免疫印迹法观察脑组织基质金属蛋白酶-9（MMP-9）表达。结果：脑缺血再灌注损伤后,随时间延长及缺氧,对照组大鼠大脑皮质和纹状体区脑组织细胞凋亡,并且胶质细胞MMP-9蛋白表达逐渐增加。治疗组大鼠经注射NRG-1β干预性治疗后,缺血脑组织梗死范围及其细胞凋亡数量相对呈明显下降趋势。胶质细胞MMP-9表达呈降低趋势。结论：大鼠脑缺血再灌注损伤后体内NRG-1β抑制胶质细胞MMP-9的表达,控制缺血脑组织梗死的范围并抑制正常细胞的凋亡,发挥了重要的抗炎作用,可作为对于大脑缺血再灌注损伤的研究新靶点。     

Role of Protein Synthesis in the Ischemic Tolerance Acquisition Induced by Transient Forebrain Ischemia in the Rat

Although ischemic preconditioning of the heart and brain is a well-documented neuroprotective phenomenon, the mechanism underlying the increased resistance to severe ischemia induced by a preceding mild ischemic exposure remains unclear. In this study we have determined the effect of ischemic preconditioning on ischemia/reperfusion-associated translation inhibition in the neocortex and hippocampus of the rat. We studied the effect of the duration on the sublethal ischemic episode (3, 4, 5 or 8 min), as well as the amount of time elapsed between sublethal and lethal ischemia on the cell death 7 days after the last ischemic episode. In addition, the rate of protein synthesis in vitro and expression of the 72-kD heat shock protein (hsp) were determined under the different experimental conditions. Our results suggest that two different mechanisms are essential for the acquisition of ischemic tolerance, at least in the CA1 sector of hippocampus. The first mechanism implies a highly significant reduction in translation inhibition after lethal ischemia, especially at an early time of reperfusion, in both vulnerable and nonvulnerable neurons. For the acquisition of full tolerance, a second mechanism, highly dependent on the time interval between preconditioning (sublethal ischemia) and lethal ischemia, is absolutely necessary; this second mechanism involves synthesis of protective proteins, which prevent the delayed death of vulnerable neurons.     

阿托伐他汀预处理对心肌缺血再灌注损伤大鼠心室重构、炎症反应和氧化应激的影响

目的:研究阿托伐他汀预处理对心肌缺血再灌注损伤大鼠心室重构、炎症反应和氧化应激的影响.方法:选取90只SD级大鼠进行研究,将其随机分成假手术组、缺血再灌注组、阿托伐他汀组,每组30只.假手术组与缺血再灌注组大鼠予以生理盐水(5 mL/d)连续灌胃7d处理,阿托伐他汀组予以阿托伐他汀20 mg/(kg-d)连续灌胃7 d...     

在无创性肢体缺血预适应中P53基因对心肌梗死后心肌细胞凋亡影响的研究

目的：通过对无创性肢体缺血预适应的动物模型观察,探讨细胞凋亡在其中的作用,以及p53基因对其进行的调控。方法：采用TUNEL标记技术研究无创性肢体缺血预适应心肌细胞中细胞凋亡现象,并采用聚合酶连反应单链构象多态法（PCR-SSCP）研究p53基因的突变情况。结果：与缺血再灌注组（I/R）相比,无创性肢体缺血预适应组（NDLIP）凋亡率较低,差别有统计学意义。NDLIP和经典缺血预适应组（IP）间差别不显著。RIP组p53基因突变率比I/R组高,差别有统计学意义,NDLIP和经典缺血预适应组（IP）间差别不显著。结论：无创性肢体缺血预适应组野生型p53基因较少,突变型p53基因较多。无创性肢体缺血预适应对心肌的保护作用可能是通过增加突变型p53基因抑制细胞凋亡来实现。