远端缺血预处理对脑缺血保护作用的研究进展_West China Medical Journal

Authors：

余超 ,  刘进

Corresponding author：

刘进, Email: 77908841@qq.com

Keywords：

远端缺血预处理; 脑缺血; 脑保护

DOI：

10.7507/1002-0179.20130096

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远端缺血预处理可以诱导脑缺血耐受形成从而产生脑保护作用，具有很强的临床应用价值。其可通过机体不太重要的器官的缺血预处理来保护重要器官如脑、心脏、肺、小肠、胃、肝等，其脑保护机制可能与内源性一氧化氮、丝裂原活化蛋白激酶通道、Notch信号、热应激蛋白70表达、抗氧化作用、抑制神经元凋亡、神经和（或）体液因素等有关。现对远端缺血预处理对脑缺血保护作用相关机制的研究现状作一综述。

Citation： 余超,刘进. 远端缺血预处理对脑缺血保护作用的研究进展. West China Medical Journal, 2013, 28(2): 298-301. doi: 10.7507/1002-0179.20130096 Copy

1.	Murry CE, Jennings RB, Reimer KA, et al. Preconditioning with ischemia: a delay of lethal cell injury in ischemic myocardium[J]. Circulation, 1986, 74(5): 1124-1136.
2.	Przyklenk K, Barbara B, Ovize M, et al. Regional ischemic preconditioning protects remote virgin myocardium from subsequence sustained coronary occlusion[J]. Circulation, 1993, 87(3): 893-899.
3.	袁恒杰, 罗琼, 朱学慧. 无创性延迟肢体缺血预适应对大鼠脑缺血再灌注皮层的保护作用[J]. 中国临床药理学与治疗学, 2009, 14(2): 144-149.
4.	Hajrasouliha AR, Tavakoli S, Ghasemi M, et al. Endogenous cannabinoids contribute to remote ischemic preconditioning via cannabinoid CB2 receptors in the rat heart[J]. Eur J Pharmacol, 2008, 579(1- 3): 246-252.
5.	Kanoria S, Jalan R, Davies NA, et al. Remote ischemic preconditioning of the hind limb reduces experimental liver warm ischemia reperfusion injury[J]. Br J Surg, 2006, 93(6): 762-768.
6.	Heidbreder M, Naumann A, Tempel K, et al. Remote ischemic preconditioning: the differential role of mitogen activated protein kinase pathways[J]. Cardiovasc Res, 2008, 78(1): 108-115.
7.	Oehmann C, Benz S, Drognitz O, et al. Remote preconditioning reduces microcirculatory disorders in pancreatic ischemia reperfusion injury[J]. Pancreas, 2007, 35(4): e45-e50.
8.	Jan WC, Chen CH, Tsai PS, et al. Limb ischemic preconditioning mitigates lung injury induced by haemorrhagic shock/resuscitation in rats[J]. Resuscitation, 2011, 82(6): 760-766.
9.	Loukogeorgakis SP, Panagiotidou AT, Broadhead MW, et al. Remote ischemic preconditioning provides early and late protection against endothelial ischemia-reperfusion injury in humans: role of the autonomic nervous system[J]. J Am Coll Cardiol, 2005, 46(3): 450-456.
10.	Tropak MB, Shi H, Li J, et al. Potent neuroprotection induced by remote preconditioning in a rat model of neonatal cerebral hypoxic ischemic injury[J]. J Thorac Cardiovasc Surg, 2011, 142(1): 233-235.
11.	Küntscher MV, Kastell T, Altmann J, et al. Acute remote ischemic preconditioning: the role of nitric oxide[J]. Microsurgery, 2002, 22(6): 227-231.
12.	Ren C, Gao X, Steinberg GK, et al. Limb remote preconditioning protects against focal ischemia in rats and contradicts the dogma of therapeutic time windows for preconditioning[J]. Neuroscience, 2008, 151(4): 1099-1103.
13.	Zhao HG, Sun XC, Xian XH, et al. The role of nitric oxide in the neuroprotection of limb ischemic preconditioning in rats[J]. Neurochem Res, 2007, 32(11): 1919-1926.
14.	Sun XC, Li WB, Li QJ, et al. Limb ischemic preconditioning induces brain ischemic tolerance via p38 MAPK[J]. Brain Res, 2006, 1084(1): 165-174.
15.	孙晓彩, 羡晓辉, 李文斌, 等. 肢体缺血预处理通过激活有丝分裂原激活蛋白激酶p38减轻脑缺血导致的大鼠海马CA1区神经元凋亡和脑水肿[J]. 中国药理学与毒理学杂志, 2008, 22(5): 321-328.
16.	Sun XC, Xian XH, Li WB, et al. Activation of p38 MAPK participates in brain ischemic tolerance induced by limb ischemic preconditioning by up-regulating HSP 70[J]. Exp Neurol, 2010, 224(3): 347-355.
17.	Jin RL, Li WB, Li QJ, et al. The role of extracellular signal-regulated kinases in the neuroprotection of limb ischemic preconditioning[J]. Neurosci Res, 2006, 55(1): 65-73.
18.	孙晓彩, 羡晓辉, 蔡劲松, 等. 超氧化物岐化酶参与p38 MAPK介导的肢体缺血预处理对大鼠全脑缺血的保护作用[J]. 中国药理学与毒理学杂志, 2007, 21(6): 455-461.
19.	赵翚, 董海龙, 熊利泽, 等. 线粒体ATP敏感性钾离子通道参与远程预处理对大鼠脑保护作用的机制[J]. 第四军医大学学报, 2007, 28(18): 1633-1635.
20.	吕文英, 熊利泽, 董海龙, 等. Notch信号在肢体远程预处理诱导脑保护机制研究[J]. 中华神经外科疾病研究杂志, 2011, 10(3): 214-217.
21.	赵红岗, 李文斌, 李清君, 等. 肢体缺血预处理对大鼠缺血再灌注海马HSP70表达的影响[J]. 中风与神经疾病杂志, 2006, 23(1): 93-96.
22.	袁恒杰, 罗琼, 朱学慧, 等. 无创性延迟肢体缺血预适应对大鼠脑缺血再灌注皮层的保护作用[J]. 中国临床药理学与治疗学, 2009, 14(2): 144-149.
23.	Yannopoulos FS, Mäkelä T, Niemelä E, et al. Improved cerebral recovery from hypothermic circulatory arrest after remote ischemic preconditioning[J]. Ann Thorac Surg, 2010, 90(1): 182-188.
24.	赵红岗, 李文斌, 李清君, 等. 肢体缺血预处理减少大鼠全脑缺血再灌注诱导的海马CA1区锥体神经元凋亡[J]. 生理学报, 2004, 56(3): 143-148.
25.	Dave KR, Saul I, Prado R, et al. Remote organ ischemic preconditioning protect brain from ischemic damage following asphyxial cardiac arrest[J]. Neurosci Lett, 2006, 404(1-2): 170-175.
26.	Saxena P, Bala A, Campbell K, et al. Does remote ischemic preconditioning prevent delayed hippocampal neuronal death following transient global cerebral ischemia in rats?[J]. Perfusion, 2009, 24(3): 207-211.
27.	胡胜, 熊利泽. 远程缺血预处理研究进展[J]. 上海医学, 2010, 33(6): 598-601.
28.	Dong HL, Zhang Y, Su BX, et al. Limb remote ischemic preconditioning protects the spinal cord from ischemia-reperfusion injury[J]. Anesthesiology, 2010, 112(4): 881-891.
29.	Shimizu M. Tropak M. Diaz RJ, et al. Transient limb ischaemia remotely preconditions through a humoral mechanism acting directly on the myocardium: evidence suggesting cross-species protection[J]. Clin Sci, 2009, 117(5): 191-200.
30.	Kingma JG Jr, Simard D, Voisine P, et al. Role of the autonomic nervous system in cardioprotection by remote preconditioning in isoflurane anaesthetized dogs[J]. Cardiovasc Res, 2011, 89(2): 384-391.
31.	Tapuria N, Kumar Y, Habib MM, et al. Remote Ischemic preconditioning: a novel protective method from ischemia reperfusion injury--a review[J]. J Surg Res, 2008, 150(2): 304-330.
32.	Bolte CS, Liao S, Gross GJ, et al. Remote preconditioning-endocrine factors in organ protection against ischemic injury[J]. Endocr Metab Immune Disord Drug Targets, 2007, 7(3): 167-175.
33.	赵红岗, 李文斌, 孙晓彩, 等. 神经途径在肢体缺血预处理抗脑缺血/再灌注损伤中的作用[J]. 中国应用生理学杂志, 2007, 23(1): 19-23.
34.	Malhotra S, Naggar I, Stewart M, et al. Neurogenic pathway mediated remote preconditioning protects the brain from transient focal ischemic injury[J]. Brain Res, 2011, 1386: 184-190.
35.	Gho BC, Schoemaker RG, van den Doel MA, et al. Myocardial protection by brief ischemia in noncardiac tissue[J]. Circulation, 1996, 94(9): 2193-2200.
36.	Lim SY, Yellon DM, Hausenloy DJ, et al. The neural and humoral pathways in remote limb ischemic preconditioning[J]. Basic Res Cardiol, 2010, 105(5): 651-655.

1. 　Murry CE, Jennings RB, Reimer KA, et al. Preconditioning with ischemia: a delay of lethal cell injury in ischemic myocardium[J]. Circulation, 1986, 74(5): 1124-1136.
2. 　Przyklenk K, Barbara B, Ovize M, et al. Regional ischemic preconditioning protects remote virgin myocardium from subsequence sustained coronary occlusion[J]. Circulation, 1993, 87(3): 893-899.
3. 　袁恒杰, 罗琼, 朱学慧. 无创性延迟肢体缺血预适应对大鼠脑缺血再灌注皮层的保护作用[J]. 中国临床药理学与治疗学, 2009, 14(2): 144-149.
4. 　Hajrasouliha AR, Tavakoli S, Ghasemi M, et al. Endogenous cannabinoids contribute to remote ischemic preconditioning via cannabinoid CB2 receptors in the rat heart[J]. Eur J Pharmacol, 2008, 579(1- 3): 246-252.
5. 　Kanoria S, Jalan R, Davies NA, et al. Remote ischemic preconditioning of the hind limb reduces experimental liver warm ischemia reperfusion injury[J]. Br J Surg, 2006, 93(6): 762-768.
6. 　Heidbreder M, Naumann A, Tempel K, et al. Remote ischemic preconditioning: the differential role of mitogen activated protein kinase pathways[J]. Cardiovasc Res, 2008, 78(1): 108-115.
7. 　Oehmann C, Benz S, Drognitz O, et al. Remote preconditioning reduces microcirculatory disorders in pancreatic ischemia reperfusion injury[J]. Pancreas, 2007, 35(4): e45-e50.
8. 　Jan WC, Chen CH, Tsai PS, et al. Limb ischemic preconditioning mitigates lung injury induced by haemorrhagic shock/resuscitation in rats[J]. Resuscitation, 2011, 82(6): 760-766.
9. 　Loukogeorgakis SP, Panagiotidou AT, Broadhead MW, et al. Remote ischemic preconditioning provides early and late protection against endothelial ischemia-reperfusion injury in humans: role of the autonomic nervous system[J]. J Am Coll Cardiol, 2005, 46(3): 450-456.
10. 　Tropak MB, Shi H, Li J, et al. Potent neuroprotection induced by remote preconditioning in a rat model of neonatal cerebral hypoxic ischemic injury[J]. J Thorac Cardiovasc Surg, 2011, 142(1): 233-235.
11. 　Küntscher MV, Kastell T, Altmann J, et al. Acute remote ischemic preconditioning: the role of nitric oxide[J]. Microsurgery, 2002, 22(6): 227-231.
12. 　Ren C, Gao X, Steinberg GK, et al. Limb remote preconditioning protects against focal ischemia in rats and contradicts the dogma of therapeutic time windows for preconditioning[J]. Neuroscience, 2008, 151(4): 1099-1103.
13. 　Zhao HG, Sun XC, Xian XH, et al. The role of nitric oxide in the neuroprotection of limb ischemic preconditioning in rats[J]. Neurochem Res, 2007, 32(11): 1919-1926.
14. 　Sun XC, Li WB, Li QJ, et al. Limb ischemic preconditioning induces brain ischemic tolerance via p38 MAPK[J]. Brain Res, 2006, 1084(1): 165-174.
15. 　孙晓彩, 羡晓辉, 李文斌, 等. 肢体缺血预处理通过激活有丝分裂原激活蛋白激酶p38减轻脑缺血导致的大鼠海马CA1区神经元凋亡和脑水肿[J]. 中国药理学与毒理学杂志, 2008, 22(5): 321-328.
16. 　Sun XC, Xian XH, Li WB, et al. Activation of p38 MAPK participates in brain ischemic tolerance induced by limb ischemic preconditioning by up-regulating HSP 70[J]. Exp Neurol, 2010, 224(3): 347-355.
17. 　Jin RL, Li WB, Li QJ, et al. The role of extracellular signal-regulated kinases in the neuroprotection of limb ischemic preconditioning[J]. Neurosci Res, 2006, 55(1): 65-73.
18. 　孙晓彩, 羡晓辉, 蔡劲松, 等. 超氧化物岐化酶参与p38 MAPK介导的肢体缺血预处理对大鼠全脑缺血的保护作用[J]. 中国药理学与毒理学杂志, 2007, 21(6): 455-461.
19. 　赵翚, 董海龙, 熊利泽, 等. 线粒体ATP敏感性钾离子通道参与远程预处理对大鼠脑保护作用的机制[J]. 第四军医大学学报, 2007, 28(18): 1633-1635.
20. 　吕文英, 熊利泽, 董海龙, 等. Notch信号在肢体远程预处理诱导脑保护机制研究[J]. 中华神经外科疾病研究杂志, 2011, 10(3): 214-217.
21. 　赵红岗, 李文斌, 李清君, 等. 肢体缺血预处理对大鼠缺血再灌注海马HSP70表达的影响[J]. 中风与神经疾病杂志, 2006, 23(1): 93-96.
22. 　袁恒杰, 罗琼, 朱学慧, 等. 无创性延迟肢体缺血预适应对大鼠脑缺血再灌注皮层的保护作用[J]. 中国临床药理学与治疗学, 2009, 14(2): 144-149.
23. 　Yannopoulos FS, Mäkelä T, Niemelä E, et al. Improved cerebral recovery from hypothermic circulatory arrest after remote ischemic preconditioning[J]. Ann Thorac Surg, 2010, 90(1): 182-188.
24. 　赵红岗, 李文斌, 李清君, 等. 肢体缺血预处理减少大鼠全脑缺血再灌注诱导的海马CA1区锥体神经元凋亡[J]. 生理学报, 2004, 56(3): 143-148.
25. 　Dave KR, Saul I, Prado R, et al. Remote organ ischemic preconditioning protect brain from ischemic damage following asphyxial cardiac arrest[J]. Neurosci Lett, 2006, 404(1-2): 170-175.
26. 　Saxena P, Bala A, Campbell K, et al. Does remote ischemic preconditioning prevent delayed hippocampal neuronal death following transient global cerebral ischemia in rats?[J]. Perfusion, 2009, 24(3): 207-211.
27. 　胡胜, 熊利泽. 远程缺血预处理研究进展[J]. 上海医学, 2010, 33(6): 598-601.
28. 　Dong HL, Zhang Y, Su BX, et al. Limb remote ischemic preconditioning protects the spinal cord from ischemia-reperfusion injury[J]. Anesthesiology, 2010, 112(4): 881-891.
29. 　Shimizu M. Tropak M. Diaz RJ, et al. Transient limb ischaemia remotely preconditions through a humoral mechanism acting directly on the myocardium: evidence suggesting cross-species protection[J]. Clin Sci, 2009, 117(5): 191-200.
30. 　Kingma JG Jr, Simard D, Voisine P, et al. Role of the autonomic nervous system in cardioprotection by remote preconditioning in isoflurane anaesthetized dogs[J]. Cardiovasc Res, 2011, 89(2): 384-391.
31. 　Tapuria N, Kumar Y, Habib MM, et al. Remote Ischemic preconditioning: a novel protective method from ischemia reperfusion injury--a review[J]. J Surg Res, 2008, 150(2): 304-330.
32. 　Bolte CS, Liao S, Gross GJ, et al. Remote preconditioning-endocrine factors in organ protection against ischemic injury[J]. Endocr Metab Immune Disord Drug Targets, 2007, 7(3): 167-175.
33. 　赵红岗, 李文斌, 孙晓彩, 等. 神经途径在肢体缺血预处理抗脑缺血/再灌注损伤中的作用[J]. 中国应用生理学杂志, 2007, 23(1): 19-23.
34. 　Malhotra S, Naggar I, Stewart M, et al. Neurogenic pathway mediated remote preconditioning protects the brain from transient focal ischemic injury[J]. Brain Res, 2011, 1386: 184-190.
35. 　Gho BC, Schoemaker RG, van den Doel MA, et al. Myocardial protection by brief ischemia in noncardiac tissue[J]. Circulation, 1996, 94(9): 2193-2200.
36. 　Lim SY, Yellon DM, Hausenloy DJ, et al. The neural and humoral pathways in remote limb ischemic preconditioning[J]. Basic Res Cardiol, 2010, 105(5): 651-655.

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远端缺血预处理对脑缺血保护作用的研究进展

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