Departament of Anatomy, Institute of Biomedical Sciences, Federal University of Alfenas (UNIFAL-MG), Brazil; Faculty of Medicine, Federal University of Alfenas (UNIFAL-MG), Brazil.
Departament of Anatomy, Institute of Biomedical Sciences, Federal University of Alfenas (UNIFAL-MG), Brazil.
Surgery. 2023 Aug;174(2):363-368. doi: 10.1016/j.surg.2023.04.033. Epub 2023 May 18.
Skeletal muscle ischemia-reperfusion injuries result in a loss of contractile function, leading to limb disability or amputation. Ischemia causes hypoxia and cellular energy failure, which is aggravated by reperfusion due to the inflammatory response and oxidative stress. The consequences of the injury vary according to the duration of the period of ischemia and reperfusion. Therefore, the present work aims to evaluate ischemia-reperfusion injuries induced in the skeletal muscles of Wistar rats submitted to 3 different application periods based on morphological and biochemical parameters.
For this, a tourniquet was applied to the root of the animals' hind limbs, occluding arterial and venous blood flow, and it was followed by reperfusion-the removal of the tourniquet. The groups were: control (without tourniquet); I30'/R60' (30 minutes of ischemia and 1 hour of reperfusion); I120'/R120' (2 hours and 2 hours); and I180'/R180' (3 hours and 3 hours).
All ischemia-reperfusion groups showed characteristics of muscle injury. Microscopic analyses of the extensor digitorum longus, soleus, tibialis anterior, and gastrocnemius muscles showed a significant increase in the number of injured muscle fibers in the ischemia-reperfusion groups compared to the control group. There were also significant differences between the ischemia-reperfusion groups in all muscles, showing a progressive increase in the degree of injury. The quantification of the number of injured muscle fibers between the muscles revealed that at I30'/R60', the soleus muscles had a higher number of injuries in relation to the other muscles, with statistical significance. In the I120'/R120' group, the gastrocnemius muscles presented a significantly greater number of injured fibers. There were no significant differences in the I180'/R180' group. The serum levels of creatine kinase in the I180'/R180' group were significantly higher than in the control and I30'/R60' groups.
Therefore, it was evident that the 3 ischemia-reperfusion models used were capable of causing cell damage, with these findings being more pronounced in the I180'/R180' group.
骨骼肌缺血再灌注损伤导致收缩功能丧失,导致肢体残疾或截肢。缺血导致缺氧和细胞能量衰竭,再灌注由于炎症反应和氧化应激而加剧。损伤的后果因缺血和再灌注的持续时间而异。因此,本工作旨在评估基于形态和生化参数,在 Wistar 大鼠骨骼肌中引起的缺血再灌注损伤。
为此,在动物后肢根部应用止血带,阻断动脉和静脉血流,然后再灌注-去除止血带。各组为:对照组(无止血带);I30'/R60'(缺血 30 分钟,再灌注 1 小时);I120'/R120'(缺血 2 小时,再灌注 2 小时);I180'/R180'(缺血 3 小时,再灌注 3 小时)。
所有缺血再灌注组均表现出肌肉损伤的特征。伸趾长肌、比目鱼肌、胫骨前肌和腓肠肌的显微镜分析显示,与对照组相比,缺血再灌注组的损伤肌纤维数量显著增加。所有肌肉的缺血再灌注组之间也存在显著差异,损伤程度呈逐渐增加。对肌肉之间损伤肌纤维数量的定量分析表明,在 I30'/R60'组中,比目鱼肌的损伤数量高于其他肌肉,具有统计学意义。在 I120'/R120'组中,腓肠肌的损伤纤维数量明显增加。在 I180'/R180'组中没有差异。I180'/R180'组的血清肌酸激酶水平明显高于对照组和 I30'/R60'组。
因此,显然使用的 3 种缺血再灌注模型都能够引起细胞损伤,而在 I180'/R180'组中这些发现更为明显。