评价 NMR-MOUSE 作为一种新方法，用于在猪模型的不同灌注状态下连续监测小肠的功能。
Evaluation of the NMR-MOUSE as a new method for continuous functional monitoring of the small intestine during different perfusion states in a porcine model.
机构信息
Department of Vascular Surgery, European Vascular Center Aachen-Maastricht, RWTH University Hospital Aachen, Aachen, Germany.
Institut für Technische und Makromolekulare Chemie, RWTH University Aachen, Aachen, Germany.
出版信息
PLoS One. 2018 Nov 2;13(11):e0206697. doi: 10.1371/journal.pone.0206697. eCollection 2018.
OBJECTIVE
The study aim was to evaluate a small low-field NMR (nuclear magnetic resonance) scanner, the NMR-MOUSE®, for detecting changes in intestinal diffusion under different (patho-) physiological perfusion states.
METHODS
Laparotomy was performed on 8 female landrace pigs (body weight 70±6 kg) and the feeding vessels of several intestinal loops were dissected. Successively, the intestinal loops were examined using O2C (oxygen to see, LEA Medizintechnik GmbH, Giessen, Germany) for microcirculatory monitoring and the NMR-MOUSE® for diffusion measurement (fast and slow components). On each loop the baseline measurement (physiological perfusion) was followed by one of the following main procedures: method 1 -ischemia; method 2 -flow reduction; method 3 -intraluminal glucose followed by ischemia; method 4 -intraluminal glucose followed by flow reduction. Additionally, standard perioperative monitoring (blood pressure, ECG, blood gas analyses) and histological assessment of intestinal biopsies was performed.
RESULTS
There was no statistical overall time and method effect in the NMR-MOUSE measurement (fast component: ptime = 0.6368, pmethod = 0.9766, slow component: ptime = 0.8216, pmethod = 0.7863). Yet, the fast component of the NMR-MOUSE measurement showed contrary trends during ischemia (increase) versus flow reduction (decrease). The slow-to-fast diffusion ratio shifted slightly towards slow diffusion during flow reduction. The O2C measurement showed a significant decrease of oxygen saturation and microcirculatory blood flow during ischemia and flow reduction (p < .0001). The local microcirculatory blood amount (rHb) showed a significant mucosal increase (pClamping(method 1) = 0.0007, pClamping(method 3) = 0.0119), but a serosal decrease (pClamping(method 1) = 0.0119, pClamping(method 3) = 0.0078) during ischemia. The histopathological damage was significantly higher with increasing experimental duration and at the end of methods 3 and 4 (p < .0001,Fisher-test).
CONCLUSION
Monitoring intestinal diffusion changes due to different perfusion states using the NMR-MOUSE is feasible under experimental conditions. Despite the lack of statistical significance, this technique reflects perfusion changes and therefore seems promising for the evaluation of different intestinal perfusion states in the future. Beforehand however, an optimization of this technology, including the optimization of the penetration depth, as well as further validation studies under physiological conditions and including older animals are required.
目的
本研究旨在评估小型低场 NMR（核磁共振）扫描仪 NMR-MOUSE®，以检测不同（病理）生理灌注状态下肠道扩散的变化。
方法
对 8 头雌性长白猪（体重 70±6kg）进行剖腹手术，并解剖多个肠袢的喂养血管。随后，使用 O2C（氧气观察仪，LEA Medizintechnik GmbH，吉森，德国）进行微循环监测和 NMR-MOUSE®进行扩散测量（快成分和慢成分）来检查肠袢。在每个肠袢上，首先进行基线测量（生理灌注），然后进行以下主要程序之一：方法 1-缺血；方法 2-血流减少；方法 3-腔内葡萄糖后缺血；方法 4-腔内葡萄糖后血流减少。此外，还进行了标准围手术期监测（血压、心电图、血气分析）和肠活检的组织学评估。
结果
在 NMR-MOUSE 测量中，没有统计学上的总体时间和方法效应（快成分：ptime = 0.6368，pmethod = 0.9766，慢成分：ptime = 0.8216，pmethod = 0.7863）。然而，在缺血（增加）与血流减少（减少）期间，NMR-MOUSE 测量的快成分显示出相反的趋势。在血流减少期间，慢扩散与快扩散的扩散比略有向慢扩散转移。O2C 测量显示，在缺血和血流减少期间，氧饱和度和微循环血流显著下降（p <.0001）。局部微循环血量（rHb）在缺血时黏膜显著增加（pClamping（方法 1）= 0.0007，pClamping（方法 3）= 0.0119），但在浆膜下减少（pClamping（方法 1）= 0.0119，pClamping（方法 3）= 0.0078）。在实验过程中，使用 NMR-MOUSE 监测不同灌注状态下肠道扩散变化是可行的。尽管没有统计学意义，但该技术反映了灌注变化，因此有望在未来评估不同的肠道灌注状态。然而，在此之前，需要对该技术进行优化，包括优化穿透深度，以及在生理条件下进行进一步的验证研究，并包括老年动物。
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