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内脏前列腺素I2释放与肠道再灌注后的“无复流”现象

Splanchnic PGI2 release and "no reflow" following intestinal reperfusion.

作者信息

Turnage R H, Kadesky K M, Bartula L, Guice K S, Oldham K T, Myers S I

机构信息

Department of Surgery, University of Texas Southwestern Medical School at Dallas, USA.

出版信息

J Surg Res. 1995 Jun;58(6):558-64. doi: 10.1006/jsre.1995.1088.

Abstract

This study examines the hypothesis that reduced splanchnic blood flow during intestinal reperfusion (IR) is associated with impaired release of the vasodilatory prostanoid PGI2. Sprague-Dawley rats underwent occlusion of the superior mesenteric artery (SMA) for 120 min and reperfusion for up to 60 min. SMA blood flow was measured by transonic flow probe and radiolabeled microspheres (141Ce and 103Ru). Sham-operated animals served as controls (SHAM). Splanchnic eicosanoid release was quantitated by measuring thromboxane B2 (TxB2, stable metabolite of TxA2), 6-keto-PGF1a (6-keto, stable metabolite of PGI2), and PGE2 within the portal vein (PV) and inferior vena cava (IVC) of animals sustaining IR and SHAM. SMA flow in IR animals was < 10% of baseline and 27% of SHAM when measured by transonic flow probe (8 +/- 2% and 29 +/- 3%, IR and SHAM, respectively, P < 0.05). Similar results were obtained when intestinal blood flow was measured with microspheres (0.33 +/- 0.12 vs 1.34 +/- 0.13 ml/min/g, IR vs SHAM, P < 0.05). The greatest change in IR-induced splanchnic eicosanoid release occurred with 6-keto. Following ischemia, 6-keto levels in the PV were twice those of SHAM (P < 0.05). Five minutes after reperfusion, PV 6-keto levels were 22 times those of controls (P < 0.05) and 4 times greater than those of the IVC (P < 0.05). By 60 min of reperfusion, levels of 6-keto were reduced to those in the IVC. These data support the hypothesis that splanchnic blood flow is critically reduced by severe IR.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

本研究检验了以下假设

肠道再灌注(IR)期间内脏血流量减少与血管舒张性前列腺素前列环素(PGI2)释放受损有关。将Sprague-Dawley大鼠的肠系膜上动脉(SMA)闭塞120分钟,再灌注长达60分钟。通过跨音速血流探头和放射性微球(141Ce和103Ru)测量SMA血流量。假手术动物作为对照(SHAM)。通过测量血栓素B2(TxB2,血栓素A2的稳定代谢产物)、6-酮-前列腺素F1α(6-酮,前列环素的稳定代谢产物)和前列腺素E2,对经历IR和SHAM的动物门静脉(PV)和下腔静脉(IVC)内的内脏类花生酸释放进行定量。用跨音速血流探头测量时,IR动物的SMA血流量<基线的10%,为SHAM的27%(分别为8±2%和29±3%,IR和SHAM,P<0.05)。用微球测量肠道血流量时得到类似结果(0.33±0.12对1.34±0.13 ml/min/g,IR对SHAM,P<0.05)。IR诱导的内脏类花生酸释放的最大变化发生在6-酮上。缺血后,PV中的6-酮水平是SHAM的两倍(P<0.05)。再灌注5分钟后,PV中的6-酮水平是对照组的22倍(P<0.05),比IVC中的水平高4倍(P<0.05)。到再灌注60分钟时,6-酮水平降至IVC中的水平。这些数据支持了严重IR会严重降低内脏血流量这一假设。(摘要截短于250字)

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