【摘要】 目的　观察兔肾缺血再灌注 (IR)损伤时肠系膜微循环和血液流变性变化 ,并探讨前列腺素I2 (PGI2 )对兔肾IR损伤的预防作用及可能机制。方法　日本大耳白兔 18只 ,随机均分为假手术组 (Contro1)组、单纯缺血再灌注 (IR)组和缺血再灌注+前列腺素I2 (IR +PGI2 )组。运用微循环显微镜自动摄像分析系统 ,于肾缺血 6 0min和再灌注 12 0min时动态观察肠系膜微血管管径、血流速度、白细胞粘附、白微栓及管周出血情况 ,并测定血液流变学指标。结果　与Control组比较 ,IR组的缺血期和再灌注期 ,肠系膜微动、静脉管径减小 (P <0 .0 1或P <0 .0 5 ) ,血流速度明显减慢 (P <0 .0 1) ,白细胞粘附聚集、白微栓及管周出血增多 (P <0 .0 1) ,以血粘度增高为主的多种血液流变学指标异常 (P <0 .0 1或P <0 .0 5 )。IR +PGI2 组微动、静脉管径、血流速度、白细胞粘附、白微栓及管周出血与IR组比较差异显著 (P <0 .0 1) ,血液流变学指标较IR组明显改善 (P <0 .0 1或P <0 0 5 ) ;与Control组比较 ,除微动、静脉管径明显增大 (P <0 .0 1)外 ,其余指标差异均无显著性 (P >0 .0 5 )。结论　肾IR机体微循环和血液流变性明显异常 ,PGI2 具有改善肾IR损伤时微循环和血液流变性异常的作用。更多还原

【Abstract】 Objective To determine whether there are the changes of mesenteric microcirculation and hemorheology during renal ischemia/reperfusion(IR) injury and the effects of prostaglandin I 2 (PGI 2) as well as to explore the possible mechanism. Methods Eighteen rabbits were randomly distributed into the sham operated group(Control group), renal ischemia/reperfusion injury group(IR group) and IR+PGI 2 group. A microcircular microscope image analysis system was used to study the diameters of arteriole and venule,the blood flow velocity, the number of adhesive leukocytes,microthrombus and hemorrhage at the time piont of 60 min of ischemia and 120 min of reperfusion respectively. At the same time,the blood samples were obtained for measurement of hemorheological indexes.Results In IR group during the period of renal IR, microvascular diameters and blood flow velocity decreased significantly(P<0.01 or P<0.05),whileas the number of adhesive leukocytes,microthrombus and hemorrhage increased remarkably compared with control group(P<0.01).In addition,the disorder of hemorheology characterized by the increase of blood viscosity was significant vs control group(P<0.01 or P<0.05).In IR+ PGI 2 group, the diameters of arteriole and venule, blood flow velocity, the number of adhesive leukocytes,microthrombus and hemorrhage had significant changes compared with IR group (P<0.01).Hemorheological indexes were improved markedly vs IR group(P<0.01 or P<0.05).Except that microvascular diameters were higher than those of control group(P<0.01),others had no significant difference from control group (P>0.05).Conclusion The microcircular and hemorheological alterations detected may play a role in the development of renal IR.PGI 2 may ameliorate renal IR injury at least in part by the improvement of the microcirculation and hemorheological condition.更多还原