Horne M M, Pascoe P J, Ducharme N G, Barker I K, Grovum W L
Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Canada.
Vet Surg. 1994 Jul-Aug;23(4):241-9. doi: 10.1111/j.1532-950x.1994.tb00478.x.
This study compared the severity of ischemic injury to the equine jejunal mucosa caused by arteriovenous obstruction (AVO) or venous obstruction (VO) with that caused by reperfusion after ischemia. The degree of mucosal damage and regeneration was scored according to a modified version of an established light microscopic classification for ischemic injury. Biopsy specimens taken after 3 and 4 hours of obstruction, and after 3 hours of obstruction and 1 hour of reperfusion, were compared. There were no changes in the severity of mucosal injury (characterized by epithelial sloughing, loss of villus architecture, and necrosis of crypt cells) at 4 hours of ischemia when compared with 3 hours of ischemia. The mucosal injury score increased by one grade in three of six and five of eight segments during reperfusion for the VO and AVO models, respectively; however, only the scores for the AVO model were significantly different from the injury caused by ischemia alone. Modification of reperfusion injury was attempted by the administration of intravenous (IV) allopurinol, dimethyl sulfoxide (DMSO), or intraluminal oxygen insufflation at the time of release of the AVO and VO. Treatments did not significantly alter either the severity of injury noted after 1 hour of reperfusion or the degree of mucosal regeneration after 48 hours of reperfusion. In this group of ponies, the severity of mucosal damage was greater after 1 hour of reperfusion for both AVO and VO.
本研究比较了动静脉阻塞(AVO)或静脉阻塞(VO)引起的马空肠黏膜缺血性损伤的严重程度与缺血后再灌注引起的缺血性损伤的严重程度。根据已建立的缺血性损伤光镜分类的修改版本对黏膜损伤和再生程度进行评分。比较了阻塞3小时和4小时后以及阻塞3小时和再灌注1小时后采集的活检标本。与缺血3小时相比,缺血4小时时黏膜损伤的严重程度(以上皮脱落、绒毛结构丧失和隐窝细胞坏死为特征)没有变化。在VO和AVO模型的再灌注过程中,六个节段中的三个和八个节段中的五个节段的黏膜损伤评分分别增加了一个等级;然而,只有AVO模型的评分与单独缺血引起的损伤有显著差异。在解除AVO和VO时,通过静脉注射(IV)别嘌醇、二甲基亚砜(DMSO)或腔内充氧来尝试减轻再灌注损伤。这些治疗方法既没有显著改变再灌注1小时后观察到的损伤严重程度,也没有改变再灌注48小时后的黏膜再生程度。在这组小马中,AVO和VO再灌注1小时后黏膜损伤的严重程度更大。