Tsuchida Toru, Kato Teiji, Yamaga Makio, Ikebe Kenshiro, Oniki Yasunari, Irie Hiroki, Takagi Katsumasa
Department of Orthopaedic Surgery, Kumamoto University, School of Medicine, 860-8556, Kumamoto, Japan.
J Surg Res. 2003 Mar;110(1):266-71. doi: 10.1016/s0022-4804(02)00067-7.
The effect of University of Wisconsin (UW) solution perfusion for extremity preservation is still unknown although it is widely used. The purpose of this study is to examine the effect of UW solution perfusion on skeletal muscle preservation in a rat model.
Rat hindlimbs were amputated and either preserved with UW solution perfusion (UW perfusion group) or given no perfusion (no-perfusion group) for 5 h at 25 degrees C. They were then transplanted to other isogeneic rats. ATP in the muscle and serum creatine phosphokinase were measured after 24 h of reperfusion. The vascular endothelial function of the femoral artery rings was measured before and after 24 h of reperfusion in the presence or absence of indomethacin (cyclooxygenase inhibitor) and L-NMMA (nitric oxide synthase inhibitor). TEA (calcium-activated potassium channel inhibitor) was also used to verify the vasodilator function. Reperfusion blood flow was monitored during the first 2 h of reperfusion.
ATP in the UW perfusion group was significantly decreased after 24 h of reperfusion, while that in the no-perfusion group recovered. Reperfusion blood flow in the UW solution perfusion group was significantly lower than that in the no-perfusion group. Acetylcholine-induced relaxation in the UW perfusion group was significantly reduced before and after 24 h of reperfusion compared to that in the no-perfusion group and was mostly diminished by indomethacin and L-NMMA administration.
Skeletal muscle injury is augmented by UW solution perfusion, probably due to deterioration of the vascular endothelial function resulting in blood supply diminution.
尽管威斯康星大学(UW)溶液灌注在肢体保存中被广泛应用,但其效果仍不明确。本研究旨在探讨UW溶液灌注对大鼠模型骨骼肌保存的影响。
将大鼠后肢截肢,在25℃下用UW溶液灌注保存(UW灌注组)或不进行灌注(非灌注组)5小时。然后将其移植到其他同基因大鼠体内。再灌注24小时后测量肌肉中的ATP和血清肌酸磷酸激酶。在存在或不存在吲哚美辛(环氧化酶抑制剂)和L-NMMA(一氧化氮合酶抑制剂)的情况下,测量再灌注24小时前后股动脉环的血管内皮功能。还使用TEA(钙激活钾通道抑制剂)来验证血管舒张功能。在再灌注的前2小时监测再灌注血流量。
再灌注24小时后,UW灌注组的ATP显著降低,而非灌注组的ATP恢复。UW溶液灌注组的再灌注血流量显著低于非灌注组。与非灌注组相比,UW灌注组在再灌注24小时前后乙酰胆碱诱导的舒张作用显著降低,并且在给予吲哚美辛和L-NMMA后大多减弱。
UW溶液灌注会加重骨骼肌损伤,可能是由于血管内皮功能恶化导致血液供应减少。