Rosero Olivér, Onody Péter, Stangl Rita, Hegedus Viktor, Lotz Gábor, Blázovics Anna, Kupcsulik Péter, Szijártó Attila
Semmelweis Egyetem, Általános Orvostudományi Kar I. sz. Sebészeti Klinika 1082 Budapest Üllői út 78.
Magy Seb. 2011 Feb;64(1):28-36. doi: 10.1556/MaSeb.64.2011.1.6.
The ischemic-reperfusion injury of the intestine, which occurs as a consequence of circulatory redistribution or occlusion of the superior mesenteric artery, is associated with high mortality rates. Postconditioning may reduce ischemic-reperfusion damage in such cases. Effects of this new surgical method were investigated in rats.
Male Wistar rats underwent 60 minutes of superior mesenteric artery occlusion in four groups: sham-operated, control and two postconditioned groups with different algorithms. Postconditioning was performed immediately at the beginning of reperfusion, by repetitive cycles of reperfusion and reocclusion. 3 cycles of 1 minute and 6 cycles of 10 seconds were applied according to groups. Intestinal microcirculation was followed by laser Doppler flowmetry. Blood and tissue samples were taken after 60 minutes of reperfusion. Histological analayses of the small intestine, measurement of serum necroenzyme levels and IL-6, mesenterial venous blood gas analyses were preformed and antioxidant state of the mucosa was investigated.
The microcirculation during the reperfusion showed significant improvement in both postconditioned groups. Histological damage, necroenzyme and IL-6 levels were significantly reduced, while antioxidant state was improved in the postconditioned groups.
Postconditioning was capable of increasing the guts chance to survive ischemic-reperfusion injury caused by superior mesenteric artery occlusion.
肠缺血再灌注损伤是由于循环再分布或肠系膜上动脉闭塞所致，其死亡率很高。在后处理情况下，这种损伤可能会减轻。本研究在大鼠中探讨了这种新手术方法的效果。
将雄性Wistar大鼠分为四组，每组均接受60分钟的肠系膜上动脉闭塞：假手术组、对照组和两组采用不同算法的后处理组。在后处理组中，于再灌注开始时立即进行后处理，即通过重复的再灌注和再闭塞循环。根据分组，分别施加3个1分钟的循环和6个10秒的循环。采用激光多普勒血流仪监测肠道微循环。再灌注60分钟后采集血液和组织样本。对小肠进行组织学分析，测定血清坏死酶水平和白细胞介素-6水平，进行肠系膜静脉血气分析，并研究黏膜的抗氧化状态。
两个后处理组在再灌注期间的微循环均有显著改善。后处理组的组织学损伤、坏死酶和白细胞介素-6水平显著降低，而抗氧化状态得到改善。
后处理能够增加肠道在肠系膜上动脉闭塞所致缺血再灌注损伤中存活的机会。
