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止血带缺血对犬骨骼肌碳水化合物代谢的影响。

Effect of tourniquet ischaemia on carbohydrate metabolism of dog skeletal muscle.

作者信息

Hörl M, Hörl W H

出版信息

Eur Surg Res. 1985;17(1):53-60. doi: 10.1159/000128447.

Abstract

Metabolic changes in blood and skeletal muscle of dogs before, during and after tourniquet ischaemia were investigated to obtain further information on cellular metabolic abnormalities and restitution during and following long-lasting blood flow interruptions. Total carbohydrate and glycogen contents in the muscle tissue fell during ischaemia and remained significantly decreased even 1 h after recirculation due to inhibition of glycogen synthetase activity. Muscle glucose concentration remained stable during ischaemia and was significantly elevated 1 h after tourniquet release. In contrast, muscle lactate concentration was elevated during ischaemia and normal after recirculation. Blood lactate, pyruvate and serum inorganic phosphate concentrations increased markedly after tourniquet release and were still significantly elevated 1 h after recirculation, whereas ketone bodies and citric acid cycle intermediates remained unchanged. Tourniquet ischaemia had no effect on muscle phosphate concentration or on the activities of proteases, protease inhibitors or hydrolases in the blood. Nevertheless, our results clearly indicate metabolic abnormalities in the blood and skeletal muscle during 5 h of tourniquet ischaemia and even after 1 h of recirculation.

摘要

为了获取更多关于长时间血流中断期间及之后细胞代谢异常和恢复情况的信息,研究了犬在止血带缺血前、缺血期间和缺血后的血液及骨骼肌代谢变化。缺血期间肌肉组织中的总碳水化合物和糖原含量下降,并且由于糖原合成酶活性受到抑制,即使在再灌注1小时后仍显著降低。缺血期间肌肉葡萄糖浓度保持稳定,止血带松开1小时后显著升高。相反,缺血期间肌肉乳酸浓度升高,再灌注后恢复正常。止血带松开后血液乳酸、丙酮酸和血清无机磷酸盐浓度显著增加,再灌注1小时后仍显著升高,而酮体和柠檬酸循环中间产物保持不变。止血带缺血对肌肉磷酸盐浓度或血液中蛋白酶、蛋白酶抑制剂或水解酶的活性没有影响。然而,我们的结果清楚地表明,在5小时的止血带缺血期间甚至再灌注1小时后,血液和骨骼肌中存在代谢异常。

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