Heuser M, Gralla O, Pfaar O, Nustede R, Gröne H J, Post S
Department of General Surgery, George-August-University, Göttingen, Germany.
Langenbecks Arch Surg. 2000 Aug;385(5):357-62. doi: 10.1007/s004230000154.
We investigated the effect of neurotensin and cholecystokinin (CCK) on intestinal microcirculation after ischemia-reperfusion.
Ischemia was induced in Wistar rats by occlusion of the superior mesenteric artery for 40 min. Ten minutes before reperfusion, infusion of either neurotensin or CCK was started. Afterwards, the microhemodynamics of the jejunum were examined by means of intravital microscopy.
Ischemia-reperfusion decreased functional capillary density from 873.4+/-18.1 to 362.5+/-8.3 cm(-1) and red blood cell velocity from 0.49+/-0.03 to 0.34+/-0.02 mm/s. Furthermore, leukocyte-endothelium interaction was increased. Neurotensin infusion significantly increased functional capillary density to 483.2+/-9.0 cm(-1) and red blood cell velocity to 0.69+/-0.01 mm/s in the mucosal capillaries compared with ischemic controls. Despite the amelioration of villus perfusion, the number of non-perfused villi significantly increased (11.8+/-3.6%) compared with ischemic controls. CCK infusion also resulted in a significant increase of functional capillary density (535.2+/-7.4 cm(-1)) and red blood cell velocity (0.67+/-0.01 mm/s). In contrast to neurotensin, the number of non-perfused villi was not increased (5.8+/-2.2%).
We conclude that neurotensin further aggravates perfusion inhomogeneity and stasis when administered during the ischemic period. In contrast, CCK has no negative influence on perfusion homogeneity after ischemia-reperfusion. It may be superior to neurotensin in the reconstitution of normal microvascular perfusion patterns after ischemia-reperfusion.
我们研究了神经降压素和胆囊收缩素（CCK）对缺血再灌注后肠道微循环的影响。
通过阻断Wistar大鼠肠系膜上动脉40分钟诱导缺血。在再灌注前10分钟开始输注神经降压素或CCK。之后，通过活体显微镜检查空肠的微循环动力学。
缺血再灌注使功能性毛细血管密度从873.4±18.1降至362.5±8.3 cm⁻¹，红细胞速度从0.49±0.03降至0.34±0.02 mm/s。此外，白细胞与内皮细胞的相互作用增加。与缺血对照组相比，输注神经降压素可使黏膜毛细血管中的功能性毛细血管密度显著增加至483.2±9.0 cm⁻¹，红细胞速度增加至0.69±0.01 mm/s。尽管绒毛灌注有所改善，但与缺血对照组相比，未灌注绒毛的数量显著增加（11.8±3.6%）。输注CCK也导致功能性毛细血管密度（535.2±7.4 cm⁻¹）和红细胞速度（0.67±0.01 mm/s）显著增加。与神经降压素不同，未灌注绒毛的数量没有增加（5.8±2.2%）。
我们得出结论，在缺血期给予神经降压素会进一步加重灌注不均匀性和血流淤滞。相比之下，CCK对缺血再灌注后的灌注均匀性没有负面影响。在缺血再灌注后恢复正常微血管灌注模式方面，它可能优于神经降压素。
