Vollmar B, Richter S, Menger M D
Institute for Clinical and Experimental Surgery, University of Saarland, Homburg/Saar, Germany.
Am J Physiol. 1996 May;270(5 Pt 1):G798-803. doi: 10.1152/ajpgi.1996.270.5.G798.
There is ongoing debate on the significance of capillary leukostasis for the manifestation of ischemia-reperfusion (I/R)-induced capillary "no-reflow". Using intravital fluorescence microscopy, we studied leukocyte trafficking through the hepatic microvasculature and the relevance of sinusoidal leukostasis for nutritive perfusion failure in rats after hepatic I/R (n = 8). Sham-operated animals (n = 8) served as controls. Hepatic reperfusion was characterized by perfusion failure of individual sinusoids and a significant increase of sinusoidal leukostasis. However, in both nonischemic and postischemic livers, the major fraction of sinusoids presenting with stagnant leukocytes were found perfused (97 +/- 1 and 73 +/- 5%, respectively), whereas only 3 +/- 1 and 27 +/- 5% failed to conduct flow. Analysis of leukocyte trafficking in sinusoids with leukostasis revealed a marked reduction of leukocyte velocity and leukocyte flux in nonischemic and postischemic livers compared with sinusoids without leukostasis. Thus stagnant leukocytes retard cellular passage through hepatic sinusoids, probably due to an increase of flow resistance. However, the fact that during postischemic reperfusion > 70% of the sinusoids accommodating stagnant leukocytes are still perfused indicates that sinusoidal leukostasis per se does not necessarily determine perfusion failure ("no-reflow") after I/R of the liver.
关于毛细血管白细胞淤滞在缺血再灌注(I/R)诱导的毛细血管“无复流”表现中的意义,目前仍存在争议。我们使用活体荧光显微镜,研究了白细胞通过肝微血管的运输情况以及肝I/R后大鼠肝血窦白细胞淤滞与营养性灌注衰竭的相关性(n = 8)。假手术动物(n = 8)作为对照。肝再灌注的特征是单个肝血窦灌注衰竭以及肝血窦白细胞淤滞显著增加。然而,在非缺血肝脏和缺血后肝脏中,发现存在白细胞淤滞的肝血窦大部分仍有灌注(分别为97±1%和73±5%),而只有3±1%和27±5%没有血流。对存在白细胞淤滞的肝血窦中白细胞运输的分析显示,与无白细胞淤滞的肝血窦相比,非缺血肝脏和缺血后肝脏中的白细胞速度和白细胞通量显著降低。因此,停滞的白细胞可能由于血流阻力增加而阻碍细胞通过肝血窦。然而,在缺血后再灌注期间,超过70%容纳停滞白细胞的肝血窦仍有灌注,这一事实表明肝血窦白细胞淤滞本身不一定决定肝脏I/R后的灌注衰竭(“无复流”)。