Lindenau K F, Bohm J, Warnke H, David H, Sajkiewicz K, Hecht A, Berisch D
Z Exp Chir. 1978;11(5):303-11.
In a complex experimental study on 52 dogs the myocardium was examined after ischemia and reperfusion of various duration. Morphologic, metabolic, and functional findings proved that a short-term reperfusion after coronary occlusion for more than 2 hours has disadvantageous effects on the regression of ischemic lesions. During the early period (up to 3 days) this is caused by the "no-reflow" phenomenon. Combined qualitative and quantitative findings are required for correct appraisal of the ultrastructural alterations after reperfusion. In acute coronary occlusion, early revascularization after passing the crucial initial phase is advantageous, because the extent of myocardia necrosis is decreased by the prolonged reperfusion, thus leaving a larger myocardiac reserve in case of re-infarction. Clinical conclusions are drawn.
在一项针对52只狗的复杂实验研究中,对不同时长缺血和再灌注后的心肌进行了检查。形态学、代谢和功能研究结果证明,冠状动脉闭塞超过2小时后的短期再灌注对缺血性病变的消退具有不利影响。在早期阶段(长达3天),这是由“无复流”现象引起的。为了正确评估再灌注后的超微结构改变,需要综合定性和定量研究结果。在急性冠状动脉闭塞时,度过关键的初始阶段后尽早进行血管再通是有利的,因为延长的再灌注可减少心肌坏死的范围,从而在再次梗死时保留更大的心肌储备。得出了临床结论。