Heuser M, Pöpken O, Kleiman I, Post S
Department of Surgery, Klinikum Mannheim, Mannheim, Germany.
J Surg Res. 2000 Aug;92(2):186-92. doi: 10.1006/jsre.2000.5898.
Octreotide (OCT) is used for the protection of pancreato-intestinal anastomoses and for treatment of acute pancreatitis. Its effect on jejunal microcirculation after ischemia-reperfusion has not been investigated.
Intestinal ischemia was induced in Wistar rats (n = 8) by occlusion of the superior mesenteric artery for 40 min. Prior to reperfusion infusion of OCT (7.5 microgram/h) was started (n = 8). Microvascular perfusion of the jejunal mucosal and muscle layers was assessed and compared with that of groups without intervention (n = 16) by means of intravital microscopy.
Ischemia-reperfusion decreased mucosal functional capillary density from 838.4 +/- 12.6 to 418.9 +/- 9.6 cm(-1). Mucosal capillary red blood cell velocity was reduced from 0.53 +/- 0.01 to 0.35 +/- 0.01 mm/s (P < 0.05). Permanent leukocyte adherence was increased. OCT without ischemia-reperfusion decreased functional capillary density (735.4 +/- 13.5 cm(-1)) and red blood cell velocity (0.46 +/- 0.01 mm/s). After reperfusion OCT led to perfusion heterogeneity demonstrated by villous stasis (26 +/- 4%) and a decrease in the index of mucosal perfusion (0.38 +/- 0.02). Functional capillary density was further decreased compared with ischemic controls (234.0 +/- 11.8 cm(-1)). Capillary red blood cell velocity was lower (0.30 +/- 0.01 mm/s) than in ischemic controls.
OCT impairs microvascular perfusion of the jejunum both under physiological conditions and after ischemia-reperfusion.
奥曲肽（OCT）用于保护胰肠吻合口及治疗急性胰腺炎。其对缺血再灌注后空肠微循环的影响尚未得到研究。
通过阻断肠系膜上动脉40分钟，在Wistar大鼠（n = 8）中诱导肠缺血。在再灌注前开始输注奥曲肽（7.5微克/小时）（n = 8）。通过活体显微镜评估空肠黏膜和肌层的微血管灌注，并与未干预组（n = 16）进行比较。
缺血再灌注使黏膜功能性毛细血管密度从838.4±12.6降至418.9±9.6 cm⁻¹。黏膜毛细血管红细胞速度从0.53±0.01降至0.35±0.01毫米/秒（P<0.05）。永久性白细胞黏附增加。未经历缺血再灌注的奥曲肽降低了功能性毛细血管密度（735.4±13.5 cm⁻¹）和红细胞速度（0.46±0.01毫米/秒）。再灌注后，奥曲肽导致灌注不均一性，表现为绒毛淤滞（26±4%）和黏膜灌注指数降低（0.38±0.02）。与缺血对照组相比，功能性毛细血管密度进一步降低（234.0±11.8 cm⁻¹）。毛细血管红细胞速度低于缺血对照组（0.30±0.01毫米/秒）。
奥曲肽在生理条件下以及缺血再灌注后均损害空肠的微血管灌注。
