Takeyoshi I, Zhang S, Nakamura K, Ikoma A, Zhu Y, Starzl T E, Todo S
Pittsburgh Transplantation Institute, Pittsburgh, PA 15213, USA.
J Surg Res. 1996 Apr;62(1):41-8. doi: 10.1006/jsre.1996.0170.
Mucosal injury caused by ischemia and reperfusion has been well documented with the small intestine, but little is known about the colon. In the present study, the effect of warm and cold ischemia on the canine colon was studied and compared to that on the small intestine. After in situ flushing, the small intestine and the colon from six beagle dogs were removed and stored for 0.5, 1.5, and 3 hr at 37 degrees C (warm ischemia) or for 1, 6, 12, 24, 36, and 48 hr at 4 degrees C (cold ischemia). Electrophysiology, permeability, biochemistry, and histopathology of the specimens at each ischemic period and after reperfusion in the Ussing chamber were determined. Warm and cold ischemia induced duration-dependent suppression of electrophysiology in both organs, but the colonic mucosa retained higher activity of absorptive enterocytes and cryptic cells than the small intestine. Only the colon showed increased permeability of FITC-conjugated Dextran from the mucosal surface to the submucosal layer after prolonged ischemia. Changes in adenine nucleotides and purine catabolites were not markedly different between the organs. Histopathologic abnormalities during ischemia and after reperfusion were more serious with the small intestine than with the colon. Compared to warm ischemia, hypothermia lessened or delayed these morphofunctional derangements in both organs, which became universally worsened after reperfusion. Colonic mucosa receives morphofunctional derangements from ischemia and reperfusion, but the severity of the damage was much less severe in the colon than in the small intestine.
缺血再灌注引起的黏膜损伤在小肠中已有充分记录，但关于结肠的情况却知之甚少。在本研究中，研究了温缺血和冷缺血对犬结肠的影响，并与小肠进行了比较。在原位冲洗后，从六只比格犬身上取出小肠和结肠，分别在37℃下储存0.5、1.5和3小时（温缺血）或在4℃下储存1、6、12、24、36和48小时（冷缺血）。测定了每个缺血期以及在尤斯灌流室再灌注后标本的电生理学、通透性、生物化学和组织病理学。温缺血和冷缺血均诱导了两个器官电生理学的时间依赖性抑制，但结肠黏膜的吸收性肠上皮细胞和隐窝细胞活性高于小肠。只有结肠在长时间缺血后，从黏膜表面到黏膜下层的异硫氰酸荧光素偶联葡聚糖通透性增加。两个器官中腺嘌呤核苷酸和嘌呤分解代谢产物的变化没有明显差异。小肠缺血期间和再灌注后的组织病理学异常比结肠更严重。与温缺血相比，低温减轻或延迟了两个器官的这些形态功能紊乱，而再灌注后这些紊乱普遍恶化。结肠黏膜会受到缺血再灌注引起的形态功能紊乱，但结肠的损伤严重程度远低于小肠。
