急性肝肾损伤是主动脉手术后最常见的并发症,严重影响围手术期患者的生存和安全。术前慢性肝肾功能不全的存在,术前血液炎症指标的存在,术中体外循环的持续时间,红细胞输注量是术后急性肝肾损伤的主要影响因素。近年来,随着氧化应激研究的进展,越来越多的证据表明,氧化应激可能导致缺血再灌注(IR)后的组织损伤.然而,动脉手术后由IR引起的远端组织氧化应激对肝脏和肾脏细胞的影响尚未阐明。
■将新西兰白兔用于实验,并分为三组。其中,两组均饲喂高脂饲料建立高甘油三酯血症大白兔模型,对照组给予普通饲料。在实验中,对白兔进行肾下腹主动脉闭塞以模拟下肢IR。使用活性氧(ROS)和丙二醛(MDA)的含量研究了下肢动脉IR后高甘油三酯水平的影响,脂肪代谢产物,缺血肌肉组织和血液组织。接受高脂饲料的一组在下肢IR之前接受了还原型谷胱甘肽(GSH)的干预。进行病理学研究以鉴定肝和肾细胞中炎性因子和炎性细胞的表达水平以及细胞凋亡。研究了IR前GSH给药对减轻脂肪组织氧化应激和减轻应激反应后肝肾损伤的作用。
■在IR之后,甘油三酯水平高的白兔缺血肌肉组织和血液组织中ROS和MDA的增加高于仅接受普通饲料或接受GSH干预的白兔。此外,对于高甘油三酯的白兔,IR后肝脏TNF-α表达水平升高。此外,TNF-α的表达显著增加,IL-6,巨噬细胞,在肾细胞中观察到T淋巴细胞。在肾小球中还观察到大量的炎症细胞和免疫复合物的形成;此外,促进细胞凋亡。
■这项研究表明,高甘油三酯水平增强了下肢动脉IR后新西兰白兔的氧化应激反应并增加了ROS的产生。高ROS水平激活肝脏和肾脏炎症因子和炎症细胞的表达,影响细胞功能并促进细胞凋亡。在高甘油三酯水平,IR后,GSH下调氧化应激中ROS的产生,从而保护肝肾功能。
UNASSIGNED: Acute liver and kidney injury is the most common complication after aortic surgery, which seriously affects the survival and safety of perioperative patients. The presence of chronic preoperative liver and renal insufficiency, presence of preoperative blood inflammation indicators, duration of intraoperative extracorporeal circulation, and volume of red blood cell transfusion are the main influencing factors for acute postoperative liver and kidney injuries. In recent years, with the research progress on oxidative stress, a growing body of evidence has demonstrated that oxidative stress may cause tissue damage after ischemia-reperfusion (IR). However, the impact of the oxidative stress of distal tissues caused by IR on liver and renal cells after arterial surgeries has not yet been elucidated.
UNASSIGNED: New Zealand white rabbits were used for the experiments and were divided into three groups. Among them, two groups were fed high-fat feed to establish a white rabbit model of hypertriglyceridemia, whereas the control group was provided with ordinary feed. In the experiment, white rabbits were subjected to occlusion of the infrarenal aorta abdominalis to simulate IR of the lower limbs. The effects of high triglyceride levels after the arterial IR of the lower limbs were investigated using the contents of reactive oxygen species (ROS) and malondialdehyde (MDA), a fat metabolite, in ischemic muscle tissues and blood tissues. One of the groups receiving high-fat feed received intervention with reduced glutathione (GSH) before IR of the lower limbs. Pathological studies were performed to identify the expression levels of inflammatory factors and inflammatory cells in liver and renal cells as well as cell apoptosis. The effects of GSH administration before IR on reducing the oxidative stress in adipose tissues and alleviating liver and kidney damage after stress response were investigated.
UNASSIGNED: After IR, the increases in ROS and MDA in ischemic muscle tissues and blood tissues were higher in white rabbits with high triglyceride levels than in those that only received ordinary feed or received intervention with GSH. In addition, for white rabbits with high triglyceride levels, the TNF-α expression levels in the liver increased after IR. Moreover, a considerable increase in the expression of TNF-α, IL-6, macrophages, and T lymphocytes were observed in renal cells. A large number of inflammatory cells and the formation of immune complexes were also noted in the glomeruli; in addition, cell apoptosis was promoted.
UNASSIGNED: This study showed that high triglyceride levels enhanced the oxidative stress response and increased ROS production in New Zealand white rabbits after arterial IR of the lower limbs. High ROS levels activated the expression of inflammatory factors and inflammatory cells in the liver and kidney, which affected cell functions and promoted apoptosis. At high triglyceride levels, GSH downregulated ROS production in oxidative stress after IR, thereby protecting liver and kidney functions.