Petrat Frank, Swoboda Sandra, de Groot Herbert, Schmitz Klaus Juergen
University Hospital Essen, Institute of Physiological Chemistry, Hufelandstr 55, 45122 Essen, Germany.
J Invest Surg. 2010 Aug;23(4):208-17. doi: 10.3109/08941931003623622.
Classical methods do not allow to rapidly quantify the heterogeneously distributed ischemia-reperfusion injury along the small intestine. We therefore established a suitable macroscopic score.
A rat model based on superior mesenteric artery occlusion (45 or 90 min ischemia; 0, 120, or 180 min reperfusion) was used on 42 rats.
Subsequent to ischemia-reperfusion or pure ischemia, macroscopic phenotypes of the small intestine were defined and differentiated based on the severity of existing petechiae and hemorrhages (macroscopic types 0-1-2-3). Analysis of the interobserver variability verified the reliability of this macroscopic differentiation. Macroscopic types were directly correlated with their histological alterations (Chiu score). On the basis of the sample hemoglobin content, a nonlinear macroscopic score (0-1-3-9) was derived from the linearly related macroscopic types. Mean macroscopic scores after 45 min ischemia/180 min reperfusion were lower than those after 90 min ischemia/120 min reperfusion. Nevertheless, all scores correlated well with their respective hemoglobin contents (R(2) = 0.87). Heterogeneous patterns of macroscopic scores that depended on the ischemic period and largely differed between individual animals were found to be distributed along the small intestine with the highest injury score at the last half of the jejunum. The iron chelator deferoxamine mesylate clearly decreased the overall tissue hemoglobin content and macroscopic score of the small intestine but local protection was restricted to the proximal and middle part of the jejunum.
The local as well as overall ischemia-reperfusion injury in the rat small intestine can be rapidly and reliably assessed macroscopically.
传统方法无法快速量化小肠中异质性分布的缺血再灌注损伤。因此，我们建立了一个合适的宏观评分系统。
对42只大鼠采用基于肠系膜上动脉闭塞的大鼠模型（缺血45或90分钟；再灌注0、120或180分钟）。
在缺血再灌注或单纯缺血后，根据现有瘀点和出血的严重程度（宏观类型0-1-2-3）对小肠的宏观表型进行定义和区分。观察者间变异性分析验证了这种宏观区分的可靠性。宏观类型与它们的组织学改变（Chiu评分）直接相关。基于样本血红蛋白含量，从线性相关的宏观类型中得出一个非线性宏观评分（0-1-3-9）。缺血45分钟/再灌注180分钟后的平均宏观评分低于缺血90分钟/再灌注120分钟后的评分。然而，所有评分与各自的血红蛋白含量均具有良好的相关性（R(2)=0.87）。发现取决于缺血时间且个体动物之间差异很大的宏观评分异质性模式沿小肠分布，空肠后半段的损伤评分最高。铁螯合剂去铁胺甲磺酸盐明显降低了小肠的总体组织血红蛋白含量和宏观评分，但局部保护仅限于空肠的近端和中部。
大鼠小肠的局部以及整体缺血再灌注损伤可以通过宏观方法快速、可靠地评估。
