《病理生理学》课程教学资源（PPT课件讲稿）Chapter 11 缺血 - 再灌注损伤 Ischemia-reperfusion injury

Chapter 1l Ischemia reperfusion injury Zhao mingyao BMC.ZZU

Chapter 11 Ischemia￾reperfusion injury Zhao Mingyao BMC.ZZU

Brief history Simple phenomenon 1955, Sewell ligated coronary artery of dog restore blood flow after deligation What ha appened

• 1955, Sewell ligated coronary artery of dog, restore blood flow after deligation. • What happened ? Brief history Simple phenomenon

Clinical Shock. dic Bypass surgery Fibrinolytic therapy Cardiopulmonary operation Organ transplantation Coronary Bypass surgery

Clinical： • Shock , DIC • Bypass surgery • Fibrinolytic therapy • Cardiopulmonary operation • Organ transplantation

Concept of Ischemia-Reperfusion Injury The restoration of blood flow after transient ischemia may induce further reversible or irreversible cellular injury

Concept of Ischemia-Reperfusion Injury The restoration of blood flow after transient ischemia may induce further reversible or irreversible cellular injury

Features of iri 1. reversible> irreversible 2. Massive in organs 3. participating factors oxygen paradox calcium paradOX pH paradox

Features of IRI： 1. reversible → irreversible 2. Massive in organs 3.participating factors oxygen paradox calcium paradox pH paradox

Perfusion fluid Perfusion fluid effect Normal o2 2 paradox Without O2 supply Ca 2+ paradox Without with Deteriorate Injury Ca2t Ca2+ Correcting pH paradox Acidosis acidosis

Without O2 Normal O2 supply Without Ca2+ with Ca2+ Deteriorate injury Acidosis Correcting acidosis effect Perfusion fluid Perfusion fluid pH paradox Ca2+ paradox O2 paradox

Section 1 Etiology of IRI 1. Duration of ischemia 2. Dependency on O2 supply 3. The condition of reperfusion reperfusion pressure, speed, T, Na, Cal, K-t Mg2+

Section 1 Etiology of IRI 1. Duration of ischemia 2. Dependency on O2 supply 3. The condition of reperfusion: reperfusion pressure, speed, T, Na+ , Ca2+, K+ , Mg2+

Effect of Ischemic time on perfusion arrhythmia of rat 100 90 80 70 60 incidence rate 50 □RVA 40 ■RVT 30 口RVF 20 00 5min 10min 30min Ischemic time (min)

Effect of Ischemic time on perfusion arrhythmia of rat 0 1 0 2 0 3 0 4 0 5 0 6 0 7 0 8 0 9 0 100 发生率（%） 5min 10min 30min 缺血时间（min) RVA RVT RVF Ischemic time incidence rate

Section 2 mechanism of ri

Section 2 mechanism of IRI

Part 1. Injury of free radicals Radiation Drugs Pollutants Aging Infection Stress xcessive

Part 1. Injury of free radicals