山东大学基础医学院：《病理生理学 Pathophysiology》课程PPT教学课件（7年制）08 Ischemia-reperfusion injury（IRI）缺血－再灌注损伤

Ischemia-reperfusion injury (rD)

Ischemia-reperfusion injury (IRI)

Introduction 1955. Sewel tied up coronary of dog, loose suddenly ventricular fibrillation Kane tied up left entricular branch of coronary of rat ECG no obvious change relieve deligation arrhythmic

Introduction 1955, Sewel tied up coronary of dog， loose suddenly ventricular fibrillation。 Kane tied up left entricular branch of coronary of rat ECG no obvious change relieve deligation arrhythmic

1972 Flore kidney IRI 1978 1981 NG odry lung Iri feenberg intestine rI

1972 Flore kidney IRI 1978 Modry lung IRI 1981 Greenberg intestine IRI

Concept based on ischemia injury of tissue and organs restoration of blood flow after transient or ischemia further reversible or irreversible cell damage ischemia reperfusion injury (IRD

Concept: based on ischemia injury of tissue and organs restoration of blood flow after transient or ischemia further reversible or irreversible cell damage ischemia reperfusion injury（IRI）

pH paradox ischemia acidosis, disorder of function and metbolism on cell severe ri pH paradox calcium paradox pre-perfuse rat heart with no calcium perfusion for 2min perfuse calcium perfusion, cell release enzyme myofibril over-constract, electron signals abnormal, calcium paradox

pH paradox ischemia acidosis , disorder of function and metbolism on cell severe IRI pH paradox calcium paradox pre-perfuse rat heart with no calcium perfusion for 2min perfuse calcium perfusion, cell release enzyme myofibril over-constract, electron signals abnormal， calcium paradox

Oxygen paradox Hypoxia liquid perfuse organ or culture without oxygen InJury estore perfusion severe Inlury

Oxygen paradox Hypoxia liquid perfuse organ or culture without oxygen injury restore perfusion severe injury

I Cause of ischemia-reperfusion injur y and affecting factor coronary in spasm + antispasmotic thrombosis thrombolytic therapy 1. cause coronary by-pass operation on heart: no-reflow organ transplant

Ⅰ. Cause of ischemia-reperfusion injur y and affecting factor coronary in spasm antispasmotic thrombosis thrombolytic therapy 1. cause coronary by-pass operation on heart: no-reflow organ transplant

2. Affecting factor small 5-10min: arrhythmia (1)ischemic (animals 20-30min: ventricular tremor time big 20-40min: reversible injury animals [40-60min: irreversible injury diversity between small and big animal

2．Affecting factor small 5-10min: arrhythmia ⑴ ischemic animals 20-30min: ventricular time tremor big 20-40min: reversible injury animals 40-60min: irreversible injury diversity between small and big animal

10% 圆图 对照 缺血 缺血加再灌 墨 ATP K Ca Changes of ischemic perfuse:ATP、Ca2+、K+

Changes of ischemic perfuse: ATP、Ca2 + 、K+

(2) collateral( u#)circulation: chronic (302 consumption rate K+1Mg21會 protection (4 electrolytes 1Nat]食Ca2食= damage (5)condition of f, pressure, pH, Na*, Ca2tprotection reperfusion (T, pressure, Na*, C a2+=, damage

⑵ collateral(侧枝) circulation：chronic ⑶ O2 consumption rate [K+ ] , [Mg2+ ] protection ⑷ electrolytes [Na+ ] , [Ca2+ ] damage (5) condition of T, pressure,pH,Na+ ,Ca2+ protection reperfusion T, pressure,Na+ ,Ca2+ damage