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目的 探讨多次缺血预处理 (IPC)对兔脊髓缺血再灌注损伤的保护作用及其机制。方法 2 4只日本大白兔随机双盲分为假手术组 (A组 )、缺血再灌注组 (B组 )和IPC保护组 (C组 ) ,每组 8只。A组不阻断主动脉 ,B组阻断主动脉 4 5min ,C组阻断主动脉 5min ,开放 5min ,反复 4次之后再阻断 4 5min。术后第 7天检测脊髓组织金属元素 (Ca、Mg、Cu、Zn)的浓度。术后观察后肢神经功能的评分、后肢针电极肌电图(EMG)和脊髓组织病理学的改变。结果 B组脊髓组织Ca、Cu的浓度较A组显著性升高 (P <0 .0 5或0 .0 1) ,Mg、Zn的浓度则显著性降低 (P <0 .0 5 )。B组脊髓组织Ca、Zn的浓度分别较C组显著性升高或降低(P <0 .0 1)。B组后肢神经功能评分均显著性低于A、C组 (P <0 .0 5或 0 .0 1) ,脊髓病理学和后肢EMG亦较C组有显著性病理改变 (P <0 .0 1)。结论 多次IPC对兔脊髓缺血再灌注损伤具有显著而又快速的保护作用 ,其保护机制与维持缺血区域Ca、Mg、Cu、Zn元素的平衡有关。
Objective To investigate the protective effect and mechanism of multiple ischemic preconditioning (IPC) on spinal cord ischemia-reperfusion injury in rabbits. Methods 2 4 Japanese white rabbits were randomly divided into sham operation group (A group), ischemia reperfusion group (B group) and IPC protection group (C group), with 8 rabbits in each group. Group A did not block the aorta, group B blocked the aorta for 45 min, group C blocked the aorta for 5 min, opened for 5 min, repeated 4 and then blocked for 4 5 min. The concentration of metal elements (Ca, Mg, Cu, Zn) in spinal cord tissue was detected on the 7th day after operation. The score of neurological function of hind limbs, the electromyogram of hind limb acupuncture (EMG) and the histopathological changes of spinal cord were observed. Results The concentrations of Ca and Cu in group B were significantly higher than those in group A (P <0.05 or 0.01), while the concentrations of Mg and Zn in group B were significantly lower (P <0.05). The concentrations of Ca and Zn in B group were significantly higher or lower than those in C group (P <0.01). The neurological function scores of hind limbs in group B were significantly lower than those in groups A and C (P <0.05 or 0.01), and pathological and hind limb EMG also had significant pathological changes (P <0. 0 1). CONCLUSION: IPC has a significant and rapid protective effect on spinal cord ischemia-reperfusion injury in rabbits. Its protective mechanism is related to maintaining the balance of Ca, Mg, Cu and Zn in the ischemic area.