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[肾动脉以下主动脉闭塞后肌病性代谢综合征的抑制方法]

[Methods of suppression of a myonephropathic metabolic syndrome after infra-renal aortic occlusion].

作者信息

Nakano H, Esato K, Mohri H

出版信息

Nihon Geka Gakkai Zasshi. 1986 Aug;87(8):889-99.

PMID:3748002
Abstract

Acute arterial occlusion of the extremities may result in severe and complex metabolic derangement. In order to evaluate the development and means of therapeutic control of metabolic derangements following the acute arterial occlusion of extremities, 32 adult mongrel dogs weighing between 7 and 15 kg underwent acute arterial occlusion by cross-clamping the infrarenal aorta. The experimental animals were divided into two groups: an untreated group, and treated group. The former was divided into three groups--12, 24 and 48 hour's arterial occlusive groups and the latter into two groups with 48 hour's arterial occlusion--tris (hydroxymethyl) aminomethane (THAM) and perfusion groups. Biochemical and electrolyte analyses were measured before occlusion, immediately before, and 1, 3, 12, 24 and 48 hours after the release of the occlusion. The SGOT, CPK, aldolase, creatinine and blood urea nitrogen levels rose after the release of the occlusion and were significantly higher in the 48 hour's group than in the 12 and 24 hour's occlusive groups. Among these enzymatic changes, the creatinine and urea nitrogen levels were high 48 hours after the release of the occlusion, though the others decreased with time after the occlusion release. The blood pH level fell after the occlusion in the untreated groups and these levels increased slowly after the release of the occlusion. However, there were no significant differences in the blood pH among the untreated groups. The acute arterial occlusion by cross-clamping the infra-renal aorta caused severe renal damage among the various organs. In the groups treated with THAM and perfusion, the SGOT, CPK, aldolase, creatinine and blood urea nitrogen levels remained almost at preocclusion levels after the release of the occlusion. There were statistically significant differences in these enzymatic changes between the treated group and the 48 hour's occlusive group without treatment. The blood pH levels in the treated groups showed minimal changes after the release of the occlusive, although there were no significant differences in the blood pH between the treated groups and the 48 hour's occlusive group without treatment. It was concluded that the intravenous administration of THAM and peripheral washing were effective against untoward metabolic changes occurring in the ischemic extremities.

摘要

肢体急性动脉闭塞可能导致严重且复杂的代谢紊乱。为了评估肢体急性动脉闭塞后代谢紊乱的发展情况及治疗控制方法,对32只体重在7至15千克之间的成年杂种狗进行肾下腹主动脉交叉钳夹以造成急性动脉闭塞。实验动物分为两组:未治疗组和治疗组。前者又分为三组——12小时、24小时和48小时动脉闭塞组,后者分为两组,即48小时动脉闭塞——三(羟甲基)氨基甲烷(THAM)组和灌注组。在闭塞前、即将闭塞前以及闭塞解除后1、3、12、24和48小时进行生化和电解质分析。闭塞解除后,血清谷草转氨酶(SGOT)、肌酸磷酸激酶(CPK)、醛缩酶、肌酐和血尿素氮水平升高,48小时组显著高于12小时和24小时闭塞组。在这些酶变化中,闭塞解除后48小时肌酐和尿素氮水平较高,而其他指标在闭塞解除后随时间下降。未治疗组闭塞后血液pH值下降,闭塞解除后缓慢上升。然而,未治疗组之间血液pH值无显著差异。肾下腹主动脉交叉钳夹造成的急性动脉闭塞在各器官中导致严重肾损伤。在THAM治疗组和灌注组中,闭塞解除后SGOT、CPK、醛缩酶、肌酐和血尿素氮水平几乎维持在闭塞前水平。治疗组与未治疗的48小时闭塞组在这些酶变化方面存在统计学显著差异。治疗组闭塞解除后血液pH值变化极小,尽管治疗组与未治疗的48小时闭塞组之间血液pH值无显著差异。得出的结论是,静脉注射THAM和外周灌注对缺血肢体发生的不良代谢变化有效。

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