Wright J G, Kerr J C, Valeri C R, Hobson R W
Department of Surgery, Boston University School of Medicine, MA.
Arch Surg. 1988 Apr;123(4):470-2. doi: 10.1001/archsurg.1988.01400280080014.
The mechanisms of ischemia-reperfusion injury in skeletal muscle remain controversial. Some investigators have demonstrated that heparin can ameliorate ischemic injury to heart, brain, and renal tissue. We investigated the ability of heparin sodium to decrease ischemia-reperfusion injury in an isolated gracilis muscle model in ten anesthetized mongrel dogs. One gracilis muscle was perfused normally while the contralateral muscle was subjected to six hours of ischemia followed by one hour of reperfusion. Five dogs were given a preischemic bolus of heparin sodium (200 U/kg, intravenously followed by a continuous infusion (15 U/kg/h, intravenously), and five control dogs received no heparin. Quantitation of skeletal muscle ischemia-reperfusion injury was determined by histochemical staining with triphenyl tetrazolium-chloride and computerized planimetry of the infarct size. Results from the ischemic muscle demonstrate a significant beneficial effect of heparinization. The nonheparinized dogs had a 72% +/- 5% infarct size, which was significantly reduced to 24% +/- 8% in the heparinized dogs. The mechanism of this protective effect may be due to heparin's anticoagulant, antiplatelet, or anti-inflammatory action.
骨骼肌缺血再灌注损伤的机制仍存在争议。一些研究人员已证明，肝素可改善心脏、大脑和肾脏组织的缺血性损伤。我们在十只麻醉的杂种犬的离体股薄肌模型中研究了肝素钠减轻缺血再灌注损伤的能力。一侧股薄肌正常灌注，而对侧肌肉经历6小时缺血，随后再灌注1小时。五只犬在缺血前给予肝素钠推注（200 U/kg，静脉注射，随后持续输注（15 U/kg/h，静脉注射），五只对照犬未接受肝素。通过用氯化三苯基四氮唑进行组织化学染色和对梗死面积进行计算机化平面测量来定量骨骼肌缺血再灌注损伤。缺血肌肉的结果表明肝素化具有显著的有益作用。未用肝素的犬梗死面积为72%±5%，而用肝素的犬梗死面积显著减少至24%±8%。这种保护作用的机制可能是由于肝素的抗凝、抗血小板或抗炎作用。
