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伴有和不伴有肠系膜侧支循环供应排除的兔肠壁缺血再灌注组织病理学改变

Ischemia-reperfusion histopathology alterations of the rabbit intestinal wall with and without exclusion of the collateral mesenteric circulation supply.

作者信息

Gomes Otoni Moreira, Brasileiro Filho Geraldo, Porto Luiz Alberto Bomjardim, Prata Pedro Henrique de Lima, Paixão Rafael de Mattos

机构信息

Department of Surgery, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte-MG, Brazil.

出版信息

Acta Cir Bras. 2010 Aug;25(4):318-21. doi: 10.1590/s0102-86502010000400003.

DOI:10.1590/s0102-86502010000400003
PMID:20676487
Abstract

PURPOSE

To evaluate the histopathology alterations of the intestinal mucosa of rabbits submitted to different times of mesenteric artery ischemia and reperfusion with and without celiac artery collateral circulation supply.

METHODS

Two groups of eight male New Zealand white rabbits (weight 2.2-3.5 kg) were used in this study. In the Group 1 animals, the proximal mesenteric artery was occluded for 60 min with an atraumatic vascular clamp, followed by reperfusion for 60 min. In the Group 2 animals the small bowel and mesentery were cut 30cm and 60cm far from the gastroduodenal pyloric transition before the proximal mesenteric artery occlusion. Small bowel biopsies were obtained before ischemia (control), after 30 min and 60 min of mesenteric ischemia and at 30 and 60 min. of mesenteric artery reperfusion.

RESULTS

In the Group I animals, the followings histopathology grade results were observed: t1, mean 0.4 + 0.29; t2, mean 1.9 +/- 0.38; t3, 1.9 +/- 0.33; t4, 1.2 +/- 0.36 and t5, 1.2 +/- 0.32. Differences between t0 and t2 and between t3 and t4 were statistically significant (p<0.05). Differences between t2 and t3 and t4 and t5 were not significant (p>0.5). In the Group II animals, it was observed: t1, mean 1.6 +/- 0.33; t2, 2.4 +/- 0.36; t3, 3.0 +/- 0.35; t4 3.4 +/- 0.31; t5, 3 +/- 031. Differences between t0 and t1, t1 and t2, and t2 and t3 were significant (p<0.05). Differences between histopathology grades results of samples t1 to t5 in Group 1 and 2 were statistically significant (p<0.5).

CONCLUSION

Microscopic examination of the biopsies revealed significant evidence of worse small bowel wall ischemia-reperfusion lesions by exclusion of the celiac artery collateral circulation supply.

摘要

目的

评估在有或无腹腔动脉侧支循环供应的情况下,经历不同时长肠系膜动脉缺血和再灌注的家兔肠黏膜的组织病理学改变。

方法

本研究使用两组共16只雄性新西兰白兔(体重2.2 - 3.5千克)。在第1组动物中,用无损伤血管夹将肠系膜上动脉近端阻断60分钟,随后再灌注60分钟。在第2组动物中,在肠系膜上动脉近端阻断前,将小肠和肠系膜在距胃十二指肠幽门交界处30厘米和60厘米处切断。在缺血前(对照)、肠系膜缺血30分钟和60分钟后以及肠系膜动脉再灌注30分钟和60分钟时获取小肠活检样本。

结果

在第1组动物中,观察到以下组织病理学分级结果:t1,平均值0.4 ± 0.29;t2,平均值1.9 ± 0.38;t3,1.9 ± 0.33;t4,1.2 ± 0.36;t5,1.2 ± 0.32。t0与t2之间以及t3与t4之间的差异具有统计学意义(p < 0.05)。t2与t3之间以及t4与t5之间的差异不显著(p > 0.5)。在第2组动物中,观察到:t1,平均值1.6 ± 0.33;t2,2.4 ± 0.36;t3,3.0 ± 0.35;t4,3.4 ± 0.31;t5,3 ± 0.31。t0与t1、t1与t2以及t2与t3之间的差异具有统计学意义(p < 0.05)。第1组和第2组样本t1至t5的组织病理学分级结果之间的差异具有统计学意义(p < 0.5)。

结论

活检样本的显微镜检查显示,排除腹腔动脉侧支循环供应后,小肠壁缺血 - 再灌注损伤明显加重。

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Acta Cir Bras. 2010 Aug;25(4):318-21. doi: 10.1590/s0102-86502010000400003.
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[Reperfusion shock after occlusion of the superior mesenteric artery and accumulation of leukocytes within the wall of the small intestine].[肠系膜上动脉闭塞后再灌注休克及白细胞在小肠壁内的聚集]
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