1st Department of Surgery, Semmelweis University, Budapest, Hungary.
1st Department of Surgery, Semmelweis University, Budapest, Hungary.
J Surg Res. 2014 Apr;187(2):427-37. doi: 10.1016/j.jss.2013.10.035. Epub 2013 Oct 21.
Mesenteric ischemia is a serious clinical condition requiring immediate surgical intervention. The unavoidable ischemic-reperfusion (IR) injury may be ameliorated using the appropriate postconditioning protocol. The aim of the present study was to investigate the optimal postconditioning algorithm in a rat model of intestinal ischemic-reperfusion injury.
Male Wistar rats were randomized into five groups (n = 10), one sham-operated, one IR, and three postconditioned groups, each with different protocols. The animals were subjected to 60 min of mesenteric ischemia, followed by 60 min of reperfusion. Postconditioning was applied at the onset of reperfusion using three different algorithms. Arterial pressure and mucosal microcirculation were monitored throughout the experiment. Mesenteric pH was determined at the early phase of reperfusion. Blood and tissue samples were taken at the end of reperfusion for histologic evaluation, serum lactate dehydrogenase, serum creatine kinase, serum tumor necrosis factor-α, serum interleukin-6, detailed mucosal antioxidant, and scavenger capacity assays.
The shorter and intermediate length cycles of postconditioning enhanced mucosal microcirculation and redox state and significantly delayed the normalization of mesenteric pH. Furthermore, milder histopathologic lesions and lower concentrations of serum necroenzymes and proinflammatory cytokines were detected compared with the IR group. The protective effect of postconditioning using longer cycles could only be seen in a tendentious manner.
In a rat model of intestinal ischemia-reperfusion, the shorter and intermediate length cycles of postconditioning proved to be more effective than the use of longer cycles.
肠系膜缺血是一种需要立即进行手术干预的严重临床情况。可以使用适当的后处理方案来减轻不可避免的缺血再灌注（IR）损伤。本研究的目的是在大鼠肠缺血再灌注损伤模型中研究最佳的后处理方案。
雄性 Wistar 大鼠随机分为五组（n=10），一组假手术组，一组 IR 组，三组后处理组，每组采用不同的方案。动物经历 60 分钟的肠系膜缺血，然后进行 60 分钟的再灌注。在后处理中，使用三种不同的方案在再灌注开始时进行后处理。在整个实验过程中监测动脉压和黏膜微循环。在再灌注的早期阶段测定肠系膜 pH 值。在再灌注结束时采集血液和组织样本，进行组织学评估、血清乳酸脱氢酶、血清肌酸激酶、血清肿瘤坏死因子-α、血清白细胞介素-6、详细黏膜抗氧化和清除能力测定。
较短和中等长度的后处理周期增强了黏膜微循环和氧化还原状态，并显著延迟了肠系膜 pH 值的正常化。此外，与 IR 组相比，还检测到较轻的组织病理学病变以及较低的血清坏死酶和促炎细胞因子浓度。与使用较长周期的后处理相比，使用更长周期的后处理的保护作用只能在一定程度上观察到。
在大鼠肠缺血再灌注模型中，较短和中等长度的后处理周期比使用较长周期的后处理更有效。
