Clark E T, Gewertz B L
Department of Surgery, University of Chicago, IL 60637.
J Vasc Surg. 1990 Feb;11(2):270-7; discussion 278-9.
Vasoactive agents, including glucagon, have been used in treatment of mesenteric ischemia. Such drugs change both intestinal blood flow and metabolism. Since reperfusion injury reflects the metabolic state of an organ as well as the duration and severity of ischemia, we investigated the effect of glucagon in a standard model of intestinal ischemia. Data were generated from denervated isoperfused rat small intestinal preparations (n = 39). Arterial and venous pressures, intestinal blood flow, and oxygen consumption were monitored. Animals were subjected to 15, 30, or 45 minutes of ischemia followed by 1 hour reperfusion. Experiments were performed without drug infusion or during intravenous glucagon administration (0.1, 0.2, or 0.4 micrograms/kg/min). After the rats were killed, histologic sections of intestine were graded 1 through 5 in a blinded fashion with 1 = normal villi and 5 = severe injury. Results (mean +/- SD) were analyzed by analysis of variance (p less than 0.05). Glucagon at all concentrations increased intestinal blood flow and oxygen consumption before ischemia. For example, with 0.2 micrograms/kg/min glucagon, intestinal blood flow increased from 80.78 +/- 13.5 to 114.79 +/- 21.02 ml/min.100 gm and oxygen consumption increased from 3.65 +/- 0.73 to 5.73 +/- 1.37 ml/min.100 gm.* Mucosal injury after ischemia reflected duration of ischemia and glucagon infusion rate. At all ischemic intervals, increased glucagon concentrations were associated with greater mucosal injury. In fact the histologic injury with 15 minutes of ischemia + 0.2 microgram/kg/min glucagon (3.04 +/- 0.49) exceeded that of 30 minutes of ischemia (2.87 +/- 0.06).(ABSTRACT TRUNCATED AT 250 WORDS)
包括胰高血糖素在内的血管活性药物已被用于治疗肠系膜缺血。这类药物会改变肠道血流和代谢。由于再灌注损伤反映了器官的代谢状态以及缺血的持续时间和严重程度,我们在标准的肠道缺血模型中研究了胰高血糖素的作用。数据来自去神经支配的等灌注大鼠小肠标本(n = 39)。监测动脉和静脉压力、肠道血流和氧耗。动物经历15、30或45分钟的缺血,随后再灌注1小时。实验在未输注药物或静脉给予胰高血糖素(0.1、0.2或0.4微克/千克/分钟)的情况下进行。大鼠处死后,对肠道组织切片进行盲法评分,1 = 正常绒毛,5 = 严重损伤。结果(均值±标准差)采用方差分析进行分析(p < 0.05)。所有浓度的胰高血糖素在缺血前均增加肠道血流和氧耗。例如,给予0.2微克/千克/分钟的胰高血糖素时,肠道血流从80.78±13.5增加至114.79±21.02毫升/分钟·100克,氧耗从3.65±0.73增加至5.73±1.37毫升/分钟·100克*。缺血后的黏膜损伤反映了缺血持续时间和胰高血糖素输注速率。在所有缺血时间段,胰高血糖素浓度升高与更严重的黏膜损伤相关。实际上,15分钟缺血 + 0.2微克/千克/分钟胰高血糖素组的组织学损伤(3.04±0.49)超过了30分钟缺血组(2.87±0.06)。(摘要截断于250字)