【摘要】 【目的】评估UW液动脉预灌洗对缺血肢体I/R损伤程度的影响,寻找减轻缺血组织I/R损伤的有效方式。【方法】建立大鼠后肢缺血模型,预灌洗组于肢体恢复血供前,应用UW液预灌洗30 min,然后恢复血供;缺血再灌注组不进行预灌洗直接恢复肢体血供,每组8只。通过监测骨骼肌再灌注血流量变化,测定血清CPK、LDH含量及骨骼肌水含量、MDA含量、SOD活性、骨骼肌细胞凋亡情况以及骨骼肌的超微结构改变,来评估骨骼肌的I/R损伤程度。【结果】恢复血供后,I/R组中骨骼肌血流过度灌注明显,峰值为健侧(216±22)%;随后血流量下降明显;UW组中未见过度灌注现象,血流灌注量维持平稳。恢复灌注2 h,UW组中血清酶含量较I/R组降低20%~30%(P<0.05),而灌注4 h和6 h,两组间差异无统计学意义(P>0.05)。缺血4 h,UW组中骨骼肌水含量、MDA含量和SOD活性与I/R组比较差异有统计学意义(P<0.05),但恢复灌注6 h,两组间比较差异无统计学意义(P>0.05)。UW液动脉预灌洗可有效抑制细胞的凋亡,维持骨骼肌超微结构的完整。【结论】UW液动脉预灌洗对减轻缺血肢体I/R损伤是一种可行的治疗方式,但其保护效果仍有待提高。更多还原

【Abstract】 【Objective】 To assess the effect of intraarterial washout with UW solution for skeletal muscle preservation during ischemia and reperfusion. 【Methods】 Ischemic rat limbs were perfused with UW solution for 0.5 h before reperfusion; controls received no perfusion. Serum CPK and LDH were measured pre-ischemia and after reperfusion(2 h, 4 h, and 6 h). Muscle water content, MDA, and SOD were assessed pre-reperfusion and after 6 h reperfusion. Apoptosis and ultrastructure in skeletal muscle were detected after 6 h reperfusion. Reperfusion blood flow was monitored during reperfusion period. 【Results】 Intraarterial washout with UW could prevent skeletal muscle luxury perfusion occurring, inhibit the apoptotic nuclei in skeletal muscle, and preserve skeletal muscle ultrastructural integrity after 6 h of reperfusion. The serum levels of CPK and LDH in UW group were significant lower than those in I / R group after 2 h of reperfusion, but no difference was observed between UW group and I / R group after 4 h and 6 h of reperfusion. After 4 h of ischemia, there were significant differences in water content, MDA, and SOD in skeletal muscle between UW group and I / R group, but no difference was found after 6 h of reperfusion. 【Conclusion】 Intraarterial washout with UW solution is effective in preserving skeletal muscle integrity against I / R insult. But this protective effect of UW solution should be improved.更多还原