Takasaki H, Hadama T, Matsushima R, Watanabe S, Shirabe J
Second Department of Surgery, Medical College of Oita, Japan.
Jpn J Surg. 1991 Mar;21(2):201-9. doi: 10.1007/BF02470909.
The removal of serum myoglobin with extracorporeal circulation using a column filled with methylmethacrylate-divinylbenzene (MMA-DVB) was studied in experimentally induced myonephropathic metabolic syndrome in the dog. All animals showed marked edema in the hind limbs and degeneration or necrosis of the adductor muscle 5 hours after the reestablishment of arterial flow. The serum levels of myoglobin, creatinine phosphokinase, glutamic oxaloacetic transaminase and aldolase increased linearly after the reperfusion of blood in the group of animals which received no extracorporeal circulation (group 1). Sediments of numerous myoglobin casts in the renal tubules and immunoreactive myoglobin in the renal epithelium of almost all the tubules were seen in 4 out of 5 cases. In the group of animals reperfused with extracorporeal circulation using the MMA-DVB column, serum myoglobin was adsorbed selectively by the column and showed a significantly lower value at 0.5, 1, 2 and 3 hours than that of the group 1 animals. Concomitantly, the immunoreactive myoglobin was absent or scant in the renal epithelium of the proximal convoluted tubule. The present study therefore indicates that extracorporeal circulation using the MMA-DVB column is useful for the removal of serum myoglobin from experimentally induced myonephropathic metabolic syndrome.
在实验诱导犬发生肌肾性代谢综合征的情况下，研究了使用填充有甲基丙烯酸甲酯 - 二乙烯基苯（MMA - DVB）的柱体通过体外循环去除血清肌红蛋白的效果。所有动物在恢复动脉血流5小时后均出现后肢明显水肿以及内收肌变性或坏死。在未进行体外循环的动物组（第1组）中，血液再灌注后，血清肌红蛋白、肌酸磷酸激酶、谷草转氨酶和醛缩酶水平呈线性升高。5例中有4例在几乎所有肾小管的肾小管上皮中可见大量肌红蛋白管型沉积物以及免疫反应性肌红蛋白。在使用MMA - DVB柱体进行体外循环再灌注的动物组中，血清肌红蛋白被柱体选择性吸附，在0.5、1、2和3小时时其值明显低于第1组动物。同时，近端小管的肾上皮中免疫反应性肌红蛋白缺失或稀少。因此，本研究表明使用MMA - DVB柱体的体外循环对于从实验诱导的肌肾性代谢综合征中去除血清肌红蛋白是有用的。
