本文選題：缺血預(yù)處理 + 缺血再灌注損傷�。� 參考：《天津醫(yī)科大學(xué)》2012年碩士論文

【摘要】：目的：缺血預(yù)處理(IPC)是以多次短暫缺血的方法提高組織或器官的缺血耐受性,減輕組織后續(xù)缺血再灌注(I／R)損傷。缺血預(yù)處理對心臟和骨骼肌等組織缺血再灌注損傷的保護作用已被實驗證實,對周圍神經(jīng)缺血再灌注損傷的保護作用報道較少。而臨床上周圍神經(jīng)缺血再灌注損傷有一定的發(fā)生率,考慮到缺血預(yù)處理的保護作用能在短時間內(nèi)被誘導(dǎo)且方法簡便易行,損傷副作用小,所以本實驗重點研究缺血預(yù)處理對周圍神經(jīng)缺血再灌注損傷是否具有保護作用,通過建立大鼠一側(cè)后肢的缺血再灌注損傷模型,進行不同條件缺血預(yù)處理干預(yù),觀察大鼠脊髓腰骶膨大段前角運動神經(jīng)元以及脛前肌組織形態(tài)學(xué)、超微結(jié)構(gòu)的變化,探討缺血預(yù)處理對缺血再灌注損傷的保護作用,為臨床有效防治此類損傷提供理論依據(jù)。 方法：健康3月齡SD大鼠64只,隨機分為8組,每組8只,以缺血6h再灌注2h和12h分為A、B兩個大組,按無預(yù)處理、預(yù)處理1次、預(yù)處理2次和預(yù)處理3次(疊加預(yù)處理時無時間間隔)分成A0、A1、A2、A3；B0、B1、B2、B38組, A0、B0為無缺血預(yù)處理的損傷對照組,其余為實驗組。做左側(cè)腹股溝切口,顯露髂總、髂內(nèi)和髂外動脈血管,以血管夾暫時夾閉阻斷血流,建立一側(cè)后肢缺血模型,預(yù)處理方式為夾閉血管阻斷血流10min復(fù)流10min。取材部位為實驗側(cè)腰骶膨大段脊髓前角和脛前肌組織,放大鏡下取材,行光鏡HE染色及透射電鏡醋酸鈾和檸檬酸鉛雙重染色,觀察不同條件缺血預(yù)處理大鼠一側(cè)后肢在遭受缺血再灌注損傷時實驗側(cè)脊髓腰骶膨大段前角運動神經(jīng)元以及后肢脛前肌組織形態(tài)學(xué)、超微結(jié)構(gòu)變化。 結(jié)果： 1.大鼠周圍神經(jīng)缺血再灌注損傷動物模型制備成功,夾閉一側(cè)髂總、髂內(nèi)和髂外動脈可有效阻斷一側(cè)后肢動脈血流,放松血管夾后,又能使血供恢復(fù),符合實驗要求。 2.光鏡下組織形態(tài)學(xué)觀察結(jié)果：A0缺血6h再灌注2h組脊髓腰骶膨大段前角運動神經(jīng)元數(shù)量減少,核溶解消失,損傷明顯,預(yù)處理后神經(jīng)元數(shù)量增多(P0.05),可見部分細胞核存在；B0缺血6h再灌注12h組神經(jīng)元細胞大部分壞死溶解,預(yù)處理后壞死溶解區(qū)域減小。 3.電鏡下超微結(jié)構(gòu)觀察：A0和B0組脊髓前角神經(jīng)元細胞核周器不同程度擴張損傷,內(nèi)質(zhì)網(wǎng)擴張、大量線粒體空泡以及核膜溶解消失,B0組損傷最重。預(yù)處理后再灌注損傷程度有所減輕,疊加預(yù)處理后損傷進一步減輕。 4.骨骼肌雖通過不同條件預(yù)處理缺血再灌注后仍出現(xiàn)損傷表現(xiàn),但損傷程度不同,相同預(yù)處理條件下的損傷程度隨再灌注時間延長而加重。再灌注時間相同的情況下,增加預(yù)處理次數(shù)可相對減輕骨骼肌的再灌注損傷。 結(jié)論： 1.缺血預(yù)處理能減輕大鼠后肢缺血再灌注后腰骶膨大段脊髓前角運動神經(jīng)元的損傷,從而具有保護作用。反復(fù)3次缺血預(yù)處理產(chǎn)生的保護作用稍優(yōu)于2次預(yù)處理,3次、2次預(yù)處理的保護作用明顯優(yōu)于1次缺血預(yù)處理。 2.缺血預(yù)處理對骨髂肌同樣有保護作用。2次預(yù)處理效果優(yōu)于1次,2次、3次預(yù)處理相比較效果相似。同樣預(yù)處理條件,在一定范圍內(nèi)時間,再灌注時間越長,損傷越嚴重。
[Abstract]:Objective: ischemic preconditioning (IPC) is a method to improve the ischemic tolerance of tissues or organs by multiple transient ischemia and reduce the injury of subsequent ischemia-reperfusion (I / R). The protective effect of ischemic preconditioning on ischemia-reperfusion injury of cardiac and skeletal muscles has been verified and the protection of ischemia reperfusion injury of peripheral nerve is made. There are few reports. There is a certain incidence of ischemic reperfusion injury in clinical peripheral nerve. It is considered that the protective effect of ischemic preconditioning can be induced in a short time and the method is simple and easy to use, and the damage side effect is small. Therefore, this experiment focuses on whether the ischemic preconditioning has protective effect on peripheral nerve ischemia reperfusion injury. The ischemia-reperfusion injury model of the hind limbs of the rat was established and the ischemic preconditioning intervention was carried out to observe the changes of the histomorphology and ultrastructure of the anterior horn of the lumbosacral lumbosacral segment of the spinal cord of the rat, and the protective effect of ischemic preconditioning on the ischemia reperfusion injury in order to effectively prevent and cure such injury in clinical. For theoretical basis.
Methods: 64 healthy 3 month old SD rats were randomly divided into 8 groups, with 8 rats in each group. With ischemic 6h reperfusion, 2h and 12h were divided into A, B, two large groups, which were pretreated 1 times without preconditioning, preconditioning 2 times and 3 preconditioning (preconditioning without time interval), A0, A1, A2, A3; B0, B1, A3, etc., the rest were the control group without ischemic preconditioning, and the remainder for the rest control group, and the rest for the rest of the control group without ischemic preconditioning. The rest were the rest of the control group, and the rest for the rest of the control group without ischemic preconditioning. The rest were the rest for the rest group, the rest were the rest control group without ischemic preconditioning. In the experimental group, the left inguinal incision was made to expose the blood vessels of the iliac and iliac internal and external iliac arteries. The blood flow was temporarily blocked by the clamp, and the ischemic model of one side hind limb was established. The preconditioning method was to clamp the blood flow of the 10min reflow 10min. to the anterior spinal cord and the anterior tibial muscle in the lumbosacral enlarged segment of the experimental side. HE staining and transmission electron microscope staining of uranium acetate and lead citrate were used to observe the histomorphology of the anterior horn of the lumbosacral anterior horn of the spinal cord and the posterior tibial muscle in the experimental side of the ischemic preconditioning rats and the ultrastructure of the posterior tibial muscle at the experimental side of ischemic preconditioning.
Result錛，

本文編號：1886293