Lindsay T F, Hill J, Ortiz F, Rudolph A, Valeri C R, Hechtman H B, Moore F D
Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115.
Ann Surg. 1992 Dec;216(6):677-83. doi: 10.1097/00000658-199212000-00010.
Lower torso ischemia and reperfusion leads to both local and remote tissue injuries. The purpose of this study was to assess the role of complement in mediating the local and remote microvascular permeability after bilateral hind limb tourniquet ischemia. Four hours of ischemia and 4 hours of reperfusion produced an increased skeletal muscle permeability index (muscle/blood 125I albumin ratio) of 2.90 +/- 0.35 compared with the index in nonischemic muscle of 0.25 +/- 0.02 (p < 0.01). Muscle wet-to-dry-weight ratio increased from 3.93 +/- 0.04 in sham to 5.55 +/- 0.09 in ischemic muscle (p < 0.0001). Lung permeability rose at 4 hours as indicated by the increased bronchoalveolar lavage (BAL)/blood 125I albumin ratio 4.36 +/- 0.41 x 10(-3) versus sham 2.64 +/- 0.28 x 10(-3) (p < 0.05) and neutrophil sequestration 0.28 +/- 0.02 U/g myeloperoxidase (MPO) versus sham 0.14 +/- 0.02 U/g (p < 0.001). Serum lytic activity of the classical but not the alternate complement pathway was reduced. The soluble complement receptor (sCR1) was used to inhibit complement activity and attenuated the increase in the permeability index after reperfusion in ischemic muscle 1.11 +/- 0.08 (p < 0.01) and reduced the lung BAL/blood 125I albumin ratio to sham levels 2.46 +/- 0.39 x 10(-3) (p < 0.05) at 6 mg/animal, without reducing the lung neutrophil sequestration, 0.24 +/- 0.02 U/g. The authors conclude that complement activation occurred during tourniquet ischemia and mediated permeability changes in the ischemic muscle and the lungs during reperfusion.
下半身缺血再灌注会导致局部和远处组织损伤。本研究的目的是评估补体在双侧后肢止血带缺血后介导局部和远处微血管通透性中的作用。与非缺血肌肉中0.25±0.02的指数相比，4小时缺血和4小时再灌注使骨骼肌通透性指数（肌肉/血液125I白蛋白比率）增加至2.90±0.35（p<0.01）。肌肉湿重与干重之比从假手术组的3.93±0.04增加到缺血肌肉组的5.55±0.09（p<0.0001）。4小时时肺通透性升高，表现为支气管肺泡灌洗（BAL）/血液125I白蛋白比率增加，为4.36±0.41×10(-3)，而假手术组为2.64±0.28×10(-3)（p<0.05），中性粒细胞滞留为0.28±0.02 U/g髓过氧化物酶（MPO），而假手术组为0.14±0.02 U/g（p<0.001）。经典补体途径而非替代补体途径的血清溶解活性降低。可溶性补体受体（sCR1）用于抑制补体活性，并减弱缺血肌肉再灌注后通透性指数的增加，至1.11±0.08（p<0.01），并在6mg/动物时将肺BAL/血液125I白蛋白比率降低至假手术水平2.46±0.39×10(-3)（p<0.05），但未降低肺中性粒细胞滞留，为0.24±0.02 U/g。作者得出结论，在止血带缺血期间发生了补体激活，并介导了再灌注期间缺血肌肉和肺中的通透性变化。
