Ozmen Selahattin, Ayhan Suhan, Demir Yavuz, Siemionow Maria, Atabay Kenan
Gazi University Faculty of Medicine, Department of Plastic, Reconstructive, and Aesthetic Surgery, Ankara, Turkey.
J Plast Reconstr Aesthet Surg. 2008 Aug;61(8):939-48. doi: 10.1016/j.bjps.2007.05.017. Epub 2007 Jul 16.
We aimed to evaluate the impact of gradual blood reperfusion on ischaemia-reperfusion injury and to explain the pathophysiology of reperfusion injury in a rat cremaster muscle microcirculation model.
Twenty-four Sprague-Dawley rats weighing 150-200 g were evaluated in three groups. Cremaster muscles were prepared for microcirculatory observations. Group I (n=8, control): no ischemia was induced. Group II (n=8, acute reperfusion): microclamps were applied to the right external iliac vessels for 150 min, then venous and arterial clamps were released at once. Group III (n=8, gradual reperfusion): microclamps were applied to the right external iliac vessels for 150 min, and then the first venous clamp was released; the arterial clamp was opened gradually by a specially designed microclamp holder (Sheey ossicle holding clamp). In all groups, following a wait of 150 min blood flow velocity was measured for 15 min and then the animals were reperfused freely for 1h. Next, red blood cell velocity, vessel diameters, functional capillary perfusion and endothelial oedema index were analysed, and rolling, migrating and adhesing leukocytes and lymphocytes were counted. All observations were videotaped for slow-motion replay. Muscle damage was evaluated histologically.
In the acute clamp release group, blood velocities increased up to 600% of their pre-ischaemic values during the post-ischaemia-reperfusion period. The numbers of rolling, adhering and transmigrating leukocytes were significantly higher and histological evaluation revealed more tissue damage in the acute reperfusion group.
Depending on histological and microcirculatory findings, gradual reperfusion was confirmed to reduce the intensity of reperfusion injury.
我们旨在评估逐步血液再灌注对缺血-再灌注损伤的影响,并解释大鼠提睾肌微循环模型中再灌注损伤的病理生理学。
对24只体重150-200克的Sprague-Dawley大鼠进行三组评估。制备提睾肌用于微循环观察。第一组(n=8,对照组):未诱导缺血。第二组(n=8,急性再灌注组):对右髂外血管应用微血管夹150分钟,然后立即松开静脉和动脉夹。第三组(n=8,逐步再灌注组):对右髂外血管应用微血管夹150分钟,然后松开第一个静脉夹;通过专门设计的微血管夹固定器(Sheey小骨夹持夹)逐渐打开动脉夹。在所有组中,等待150分钟后测量15分钟的血流速度,然后让动物自由再灌注1小时。接下来,分析红细胞速度、血管直径、功能性毛细血管灌注和内皮水肿指数,并计数滚动、迁移和黏附的白细胞及淋巴细胞。所有观察均录像以供慢动作重放。通过组织学评估肌肉损伤。
在急性夹闭释放组中,缺血-再灌注后时期血流速度增加至缺血前值的600%。急性再灌注组中滚动、黏附和迁移的白细胞数量显著更高,组织学评估显示组织损伤更严重。
根据组织学和微循环结果,证实逐步再灌注可降低再灌注损伤的强度。