【摘要】 目的研究缺血前局部使用腺苷对猪背阔肌瓣缺血耐受的促进作用和机理。方法用不同剂量(0,0.5,2.0mg)的腺苷从腋动脉穿刺注入肌瓣,肌瓣缺血4,48小时后切取肌瓣,染色后测定肌瓣成活率,腺苷注射前、后,缺血后分别采取肌肉标本做三磷酸腺苷(ATP)定量分析。结果腺苷注射组肌肉坏死率明显低于对照组(对照组:40.3％±2.2％),0.5mg 组:20.6％±1.6％,2mg 组:18.2％±1.0％)。腺苷注入组缺血后肌肉 ATP 水平明显高于对照组。结论缺血前局部使用小剂量腺苷对缺血肌瓣有保护作用,并伴随肌肉 ATP 分解水平的减低。更多还原

【Abstract】 Objective The present project was to investigate the efficacy and mechanism of acute (10-minute)adenosine treatment for augmentation of ischemic tolerance of muscle flaps in the pig. Method Varying doses of adenosine were infused into 30 latissimus dorsi muscle flaps through the axil- lary artery(0,0.5,or 2.0 mg per flap)within 10 minutes.Ten minutes after adenosine infusion,these muscle flaps were subjected to 4 hours of sustained warm global ischemia.Muscle biopsies(n=5)for adenosine triphosphate(ATP)analysis were obtained before and after adenosine infusion and at the end of ischemia.The extent of muscle infarction was assessed at 48 hours of reperfusion by the tetrazolium dye staining technique.Result Adenosine,at all doses tested,significantly(p<0.05)reduced the ex- tent of muscle infarction in latissimus dorsi muscle flaps(control:40.3±2.2%;0.5mg:20.6±1.6%; 2.0 mg:18.2±1.0%).Preischemic adenosine treatment was associated with maintenance of a signifi- cantly(p<0.05)higher content of ATP in latissimus dorsi muscle flaps at the end of 4 hours of is- chemia compared with saline-treated control.Conclusion Acute(10-minute)preischemic adenosine treatment is effective in augmentation of ischemic tolerance of muscle flaps and that this protective effect of adenosine may be,at least in part,the result of slowing muscle ATP depletion during sustained is- chemia.The possible mechanism of this adenosine-induced energy sparing effect is discussed.更多还原