Department of Cardiac and Thoracic Vascular Surgery, Philipps University of Marburg, Marburg, Germany.
J Surg Res. 2011 Jul;169(1):156-61. doi: 10.1016/j.jss.2009.08.017. Epub 2009 Sep 10.
There is currently no efficient and reliable clinical means of assessing the degree of ischemia- and reperfusion-associated damage in microvascular transplants. The objective was to study correlation of tissue oxygen tension measurements with tissue oxygen saturation, cytochrome oxidase redox state, and tissue viability.
Latissimus dorsi muscle was dissected and mobilized in New Zealand white rabbits (n = 30, 2.5 ± 0.5 kg). Muscles were exposed to warm ischemia in two groups with either 4 or 6 h, followed by reperfusion. Tissue PO(2) was measured with a miniature intramuscular oxygen sensor (Licox microprobe; Integra Neurosciences, Ratingen, Germany) all along with tissue hemoglobin saturation (rSO(2)) and cytochrome oxidase aa3 redox state (CytOx) by in vivo near-infrared spectroscopy. Linear correlation was performed between tissue PO(2) and rSO(2), CytOx and tissue viability.
After ischemia and reperfusion, tissue PO(2) and CytOx recovery was significantly decreased in both groups compared with control (4 h: P < 0.05; 6 h: P < 0.01). Significant correlations between changes in tissue PO(2) and rSO(2) (r = 0.92; P < 0.01), CytOx (r = 0.90; P < 0.01), wet-to-dry ratio (r = -0.97; P < 0.01), and mitochondrial viability index (r = 0.97; P < 0.01) were found.
Tissue oxygen tension measured with microprobes correlated closely with tissue oxygenation, cellular oxygen utilization, and the extent of ischemia reperfusion injury.
目前，尚无有效的、可靠的临床手段来评估微血管移植物缺血再灌注损伤的程度。本研究旨在探讨组织氧张力测量与组织氧饱和度、细胞色素氧化酶氧化还原状态和组织活力之间的相关性。
在新西兰白兔（n = 30，2.5 ± 0.5 kg）中解剖并游离背阔肌。两组肌肉分别缺血 4 或 6 h 后再灌注。用微型肌内氧传感器（Licox 微探头；Integra Neurosciences，Ratingen，Germany）测量组织 PO2 ，同时通过体内近红外光谱测量组织血红蛋白饱和度（rSO2）和细胞色素氧化酶 aa3 氧化还原状态（CytOx）。对组织 PO2 与 rSO2、CytOx 与组织活力之间的线性相关性进行了分析。
缺血再灌注后，两组肌肉的组织 PO2 和 CytOx 恢复均明显低于对照组（4 h：P < 0.05；6 h：P < 0.01）。组织 PO2 与 rSO2（r = 0.92；P < 0.01）、CytOx（r = 0.90；P < 0.01）、湿重/干重比值（r = -0.97；P < 0.01）和线粒体活力指数（r = 0.97；P < 0.01）之间存在显著相关性。
用微探头测量的组织氧张力与组织氧合、细胞氧利用以及缺血再灌注损伤的程度密切相关。
