Neumayer Christoph, Fügl Alexander, Nanobashvili Josef, Blumer Roland, Punz Andreas, Gruber Helmut, Polterauer Peter, Huk Ihor
Department of Vascular Surgery, Medical University of Vienna, Vienna, Austria.
J Surg Res. 2006 Jun 15;133(2):150-8. doi: 10.1016/j.jss.2005.12.005. Epub 2006 Feb 3.
Ischemia/reperfusion (I/R) injury is characterized by the production of oxygen-free radicals leading to disturbances in vasomotility (microvascular constriction) and microvascular permeability (interstitial edema formation). The objective was to evaluate the effect of the combined antioxidative and enzymatic preparation Phlogenzym on I/R injury of skeletal muscle.
A rabbit hindlimb model of I/R (2.5/2 h) was used (IR group). Phlogenzym, containing rutin, trypsin, and bromelain, was applied enterally (60 mg/kg body weight) as a bolus 30 min prior to ischemia (Ph group). Sham-operated animals served as controls (CO group). Plasma malondialdehyde, potassium, and microvascular perfusion (monitored by laser flowmetry) were assessed. Histomorphometry and electron microscopy were performed from major adductor muscles.
Two hours after reperfusion, potassium levels were significantly elevated in IR compared to Ph group (6.7 +/- 1.2 versus 4.9 +/- 0.9 mmol/l, P < 0.006). Enhanced lipid peroxidation, apparent by increased plasma malondialdehyde levels, was ameliorated in the Ph group (1.0 +/- 0.1 versus 0.7 +/- 0.1 nmol/ml, P < 0.0001). No-reflow (reduction of blood flow by 62% in IR group) was not observed in the Ph group (P < 0.004). Phlogenzym treatment prevented microvascular constriction (17.6 +/- 2.3 versus 12.6 +/- 1.1 microm(2), P < 0.0001) and mollified interstitial edema (21.5 +/- 2.0 versus 26.0 +/- 3.7%, P < 0.017), resulting in mild ultrastructural alterations in contrast to pronounced sarcolemmal and mitochondrial damage in untreated rabbits.
Phlogenzym had a protective effect on skeletal muscle during I/R injury expressed by prevention of no-reflow and preservation of muscle tissue.
缺血/再灌注（I/R）损伤的特征是产生氧自由基，导致血管运动功能紊乱（微血管收缩）和微血管通透性改变（间质水肿形成）。目的是评估抗氧化和酶制剂Phlogenzym对骨骼肌I/R损伤的影响。
采用兔后肢I/R模型（2.5/2小时）（IR组）。在缺血前30分钟经肠道给予含芦丁、胰蛋白酶和菠萝蛋白酶的Phlogenzym（60mg/kg体重）作为推注（Ph组）。假手术动物作为对照组（CO组）。评估血浆丙二醛、钾离子水平以及微血管灌注（通过激光血流仪监测）。对主要内收肌进行组织形态计量学和电子显微镜检查。
再灌注2小时后，与Ph组相比，IR组钾离子水平显著升高（6.7±1.2对4.9±0.9mmol/L，P<0.006）。血浆丙二醛水平升高表明脂质过氧化增强，Ph组有所改善（1.0±0.1对0.7±0.1nmol/ml，P<0.0001）。Ph组未观察到无复流现象（IR组血流减少62%）（P<0.004）。Phlogenzym治疗可防止微血管收缩（17.6±2.3对12.6±1.1μm²，P<0.0001）并减轻间质水肿（21.5±2.0对26.0±3.7%，P<0.017），与未治疗兔子明显的肌膜和线粒体损伤相比，仅导致轻微的超微结构改变。
Phlogenzym对骨骼肌I/R损伤具有保护作用，表现为预防无复流现象和保护肌肉组织。
