Szijártó Attila, Turóczi Zsolt, Arányi Péter, Garbaisz Dávid, Varga Márk, Stangl Rita, Lotz Gábor, Kupcsulik Péter
Semmelweis Egyetem I. sz. Sebészeti Klinika 1082 Budapest Üllői út 78.
Magy Seb. 2010 Dec;63(6):374-9. doi: 10.1556/MaSeb.63.2010.6.4.
Surgical treatment for acute limb ischemia is revascularization or - when the limb is in a critical stage - amputation. Correct staging of the disease is relatively difficult, therefore complication and mortality rates are extremely high. Our aim was to invesitigate acute critical ischemia in rats and to test postconditioning on this model.
Experiment I: male Wistar rats underwent 4, 6, 8 hours of bilateral lower limb ischemia without reperfusion. Experiment II: suspected critical ischemia was followed by 2 hours of reperfusion with or without postconditioning. Histological samples were collected for routine staining and nitroblue-tetrazolium (NBT) enzyme-histochemistry. In Experiment II the microcirculatory changes were measured by laser Doppler flowmetry and blood samples were collected for laboratory testing (kreatin-kinase, CK).
Experiment I: After an eight-hour-obstruction, severe ischemic lesions were detectable, with rutine and NBT stainings, therefore 8 hours of ischemia was chosen for further testing. Experiment II: The CK levels showed significant (p < 0.05) drop, quantitative evaluation of enzyme-histochemisty resulted in significantly (p < 0.001) less viability depletion and microcirculation showed significant (p < 0.05) amelioration of the reperfusion parameters in the postconditioned group compared to the control.
Eight hours of lower limb ischemia is a suitable model to investigate acute critical ischemia in rats. Postconditioning could be a feasible technique to reduce IR injury associated with acute lower limb ischemia.
急性肢体缺血的外科治疗方法是血管再通术,或者在肢体处于危急阶段时进行截肢。该疾病的正确分期相对困难,因此并发症和死亡率极高。我们的目的是研究大鼠急性严重缺血情况,并在此模型上测试缺血后处理。
实验一:雄性Wistar大鼠经历4、6、8小时的双下肢缺血且不进行再灌注。实验二:疑似严重缺血后进行2小时再灌注,再灌注时进行或不进行缺血后处理。收集组织学样本进行常规染色和硝基蓝四氮唑(NBT)酶组织化学分析。在实验二中,通过激光多普勒血流仪测量微循环变化,并采集血样进行实验室检测(肌酸激酶,CK)。
实验一:在八小时阻塞后,通过常规和NBT染色可检测到严重的缺血性病变,因此选择8小时缺血用于进一步测试。实验二:与对照组相比,缺血后处理组的CK水平显著下降(p < 0.05),酶组织化学定量评估显示存活能力消耗显著减少(p < 0.001),并且微循环显示再灌注参数有显著改善(p < 0.05)。
八小时下肢缺血是研究大鼠急性严重缺血的合适模型。缺血后处理可能是一种可行的技术,可减少与急性下肢缺血相关的缺血再灌注损伤。