Morgan R A, Cikrit D F, Dalsing M C
Department of Surgery, Indiana University Medical Center, Indianapolis 46202.
Am J Surg. 1993 Aug;166(2):103-7. doi: 10.1016/s0002-9610(05)81038-4.
The ability of a solution of low-vanadium-content (less than 1 ppm) adenosine triphosphate and magnesium chloride (ATP/MgCl2) versus normal saline to improve recovery of function and reduce necrosis of skeletal muscle after severe ischemia was investigated in an in situ autoperfused canine hind limb model. The study consisted of 12 dogs divided into 3 study groups: nonischemic control (NIL) (n = 7 limbs), ischemic (IL) (n = 7 limbs), and ischemic ATP/MgCl2-treated (IATP) (n = 7 limbs). In groups IL and IATP, the limb was reperfused for 3 hours following 4 hours of complete ischemia. In IATP limbs, 200 mumol/kg of ATP/MgCl2 was infused upon reperfusion of the limbs, whereas IL limbs received a similar volume of normal saline at the time of reperfusion. Function was determined by stimulating the deep peroneal nerve and anterior tibial muscle and measuring the resultant isometric twitch contractile force of paw dorsiflexion. Muscle necrosis was evaluated by photographic analysis of sectioned anterior tibial muscle stained with nitroblue tetrazolium dye. ATP/MgCl2 significantly increased functional recovery (p < 0.01) and significantly reduced skeletal muscle necrosis (p < 0.01). This study suggests that ATP/MgCl2 may be useful in reducing the clinical sequelae of severe limb ischemia and reperfusion.
在原位自灌注犬后肢模型中，研究了低钒含量（小于1 ppm）的三磷酸腺苷和氯化镁溶液（ATP/MgCl₂）与生理盐水相比，对严重缺血后骨骼肌功能恢复和坏死减少的能力。该研究包括12只犬，分为3个研究组：非缺血对照组（NIL）（n = 7条肢体）、缺血组（IL）（n = 7条肢体）和缺血ATP/MgCl₂治疗组（IATP）（n = 7条肢体）。在IL组和IATP组中，肢体在完全缺血4小时后再灌注3小时。在IATP组肢体中，肢体再灌注时注入200 μmol/kg的ATP/MgCl₂，而IL组肢体在再灌注时接受相同体积的生理盐水。通过刺激腓深神经和胫前肌并测量由此产生的爪背屈等长收缩力来确定功能。通过对用硝基蓝四氮唑染料染色的胫前肌切片进行摄影分析来评估肌肉坏死。ATP/MgCl₂显著提高了功能恢复（p < 0.01），并显著减少了骨骼肌坏死（p < 0.01）。这项研究表明，ATP/MgCl₂可能有助于减少严重肢体缺血和再灌注的临床后遗症。
