Onody Péter, Rosero Olivér, Kovács Tibor, Garbaisz Dávid, Hegedüs Viktor, Lotz Gábor, Harsányi László, Szijártó Attila
Semmelweis Egyetem, Általános Orvostudományi Kar I. sz. Sebészeti Klinika 1082 Budapest Üllői út 78.
Magy Seb. 2012 Aug;65(4):222-9. doi: 10.1556/MaSeb.65.2012.4.9.
The ischemia-reperfusion injury of the small intestine is a condition of high mortality, which occurs following superior mesenteric artery (SMA) embolization or circulatory redistribution. The aim of the study was to evaluate the local and systemic effects of postconditioning in a rat model of small intestine ischemia-reperfusion.
Male Wistar rats underwent 60 min ischemia by the clamping of the SMA, followed by 6 hrs of reperfusion. The animals (n = 30) were randomized into three groups: sham-operated, control-, and postconditioned. Postconditioning was performed at the very onset of reperfusion by 6 alternating cycles of 10-10 seconds reperfusion/reocclusion, for a total of 2 min. At the end of the reperfusion blood and tissue (small intestine, lungs, kidney, liver) samples were taken for histological examination. The antioxidant status of small intestine was measured from intestinal homogenates.
Histologic results revealed increased damage in control-group lungs, kidney, liver and small intestine in comparison with the postconditioned group. The injury was supported by significantly higher wet/dry weight ratio (p = 0.026), and serum levels of creatinine (p = 0.013), ASAT (p = 0.038), LDH (p = 0.028) and CK (p = 0.038) in the control group. The postconditioned group showed lower serum IL-6 levels (420 pg/ml vs. 188 pg/ml), as well as significantly higher mucosal antioxidant concentration.
Postconditioning was able to decrease not only local, but the systemic damage intensity also, after a small intestinal ischemic-reperfusion episode.
小肠缺血再灌注损伤是一种死亡率很高的病症，发生于肠系膜上动脉（SMA）栓塞或循环再分布之后。本研究的目的是评估后处理在大鼠小肠缺血再灌注模型中的局部和全身效应。
雄性Wistar大鼠通过夹闭SMA进行60分钟缺血，随后再灌注6小时。将动物（n = 30）随机分为三组：假手术组、对照组和后处理组。在再灌注开始时通过6个10 - 10秒再灌注/再闭塞的交替循环进行后处理，共2分钟。在再灌注结束时采集血液和组织（小肠、肺、肾、肝）样本进行组织学检查。从小肠匀浆中测量小肠的抗氧化状态。
组织学结果显示，与后处理组相比，对照组的肺、肾、肝和小肠损伤增加。对照组的湿/干重比显著更高（p = 0.026），血清肌酐水平（p = 0.013）、谷草转氨酶（p = 0.038）、乳酸脱氢酶（p = 0.028）和肌酸激酶（p = 0.038）也支持了这种损伤。后处理组的血清IL - 6水平较低（420 pg/ml对188 pg/ml），以及黏膜抗氧化剂浓度显著更高。
在小肠缺血再灌注事件后，后处理不仅能够降低局部损伤强度，还能降低全身损伤强度。
