Xing X, Guo E, Xu F
Department of Plastic Surgery, Changhai Hospital, Second Military Medical University.
Zhonghua Zheng Xing Shao Shang Wai Ke Za Zhi. 1995 Jul;11(4):270-3.
The circulation was stopped by tourniquet in one rabbit hindlimb. After 2 or 5 hr of ischemia, the hindlimb was reperfused. During the first 1 hr of reperfusion, dynamic changes in surface microcirculation of extensor digitorum longus tendon were observed by using intravital microscopy. Particular attention was paid to leukocyte-endothelium adhesion and microvascular perfusion condition. It was found that 1) the number of leukocytes adherent to the venular endothelium of ischemic tissue significantly increased following reperfusion and the degree of increases appeared to be directly related to the duration of ischemic period; 2) reperfusion after 5 hr of ischemia could result in the formation of "no reflow phenomenon" in the ischemic tissues, including "primary no reflow" and "secondary capillary perfusion failure". These results suggest that 1) leukocyte-endothelium adhesion may contribute to the development of ischemia reperfusion injury; 2) in the limbs undergone 5 hr of ischemia, not all injuries that occur after ischemi-reperfusion can be attributed to ischemia reperfusion injury. The injury seen some in areas may be produced by ischemia alone, and in others ischemia-reperfusion-secondary ischemia injury may be responsible.
用止血带阻断一只兔后肢的血液循环。缺血2小时或5小时后，对后肢进行再灌注。在再灌注的最初1小时内，通过活体显微镜观察趾长伸肌腱表面微循环的动态变化。特别关注白细胞与内皮细胞的黏附以及微血管灌注情况。结果发现：1）再灌注后，缺血组织小静脉内皮上黏附的白细胞数量显著增加，且增加程度似乎与缺血时间直接相关；2）缺血5小时后再灌注可导致缺血组织中出现“无复流现象”，包括“原发性无复流”和“继发性毛细血管灌注衰竭”。这些结果表明：1）白细胞与内皮细胞的黏附可能促成缺血再灌注损伤的发生；2）在经历5小时缺血的肢体中，缺血再灌注后出现的损伤并非都可归因于缺血再灌注损伤。某些区域所见的损伤可能仅由缺血产生，而其他区域可能是缺血 - 再灌注 - 继发性缺血损伤所致。
