Institute for Experimental Surgery, University of Rostock, Schillingallee 69a, 18055, Rostock, Germany.
Langenbecks Arch Surg. 2011 Jan;396(1):13-29. doi: 10.1007/s00423-010-0727-x. Epub 2010 Nov 19.
Intestinal ischemia and reperfusion (I/R) is a challenging and life-threatening clinical problem with diverse causes. The delay in diagnosis and treatment contributes to the continued high in-hospital mortality rate.
Experimental research during the last decades could demonstrate that microcirculatory dysfunctions are determinants for the manifestation and propagation of intestinal I/R injury. Key features are nutritive perfusion failure, inflammatory cell response, mediator surge and breakdown of the epithelial barrier function with bacterial translocation, and development of a systemic inflammatory response. This review provides novel insight into the basic mechanisms of damaged intestinal microcirculation and covers therapeutic targets to attenuate intestinal I/R injury.
The opportunity now exists to apply this insight into the translation of experimental data to clinical trial-based research. Understanding the basic events triggered by intestinal I/R may offer new diagnostic and therapeutic options in order to achieve improved outcome of patients with intestinal I/R injury.
肠缺血再灌注（I/R）是一种具有多种病因的具有挑战性和危及生命的临床问题。诊断和治疗的延迟导致住院死亡率持续居高不下。
过去几十年的实验研究表明，微循环功能障碍是肠 I/R 损伤表现和发展的决定因素。主要特征是营养灌注衰竭、炎症细胞反应、介质激增以及上皮屏障功能的破坏导致细菌易位和全身炎症反应的发生。本综述提供了对受损肠道微循环基本机制的新见解，并涵盖了减轻肠道 I/R 损伤的治疗靶点。
现在有机会将这种对实验数据的深入了解应用于基于临床试验的研究。了解肠道 I/R 引发的基本事件可能为患者提供新的诊断和治疗选择，从而改善肠 I/R 损伤患者的预后。
