Koh K S, Lee D G, Leem T W
Asan Medical Center, University of Ulsan, Seoul, Korea.
Ann Plast Surg. 1997 Mar;38(3):252-6. doi: 10.1097/00000637-199703000-00011.
Depleted levels of adenosine triphosphate (ATP) are described as one of the important causes of skin flap failure. This study evaluated the beneficial effects of intra-arterial perfusion of ATP-magnesium chloride (MgCl2) in ischemic neurovascular skin island flaps in the rat and observed the changes of the highenergy phosphate metabolite using phosphorus 31-(P31) magnetic resonance spectroscopy (MRS). The changes of ATP, phosphocreatine (PCr), and inorganic phosphate (Pi) were observed from P31 MRS and the ratios of each metabolite were compared. The extent of skin flap survival was assessed 7 days after operation using an image analyzer. The PCr/Pi ratio of the experimental group (ATP-MgCl2) was significantly different from the control group (balanced salt solution; p < 0.05). Furthermore, the infusion of ATP-MgCl2 (40.3%) significantly improved the area of flap survival compared to the control group (14.2%; p < 0.05). The ratios of PCr/Pi PCr/(PCr + Pi) correlated with the extent of flap survival, and correlation coefficients were 0.59 and 0.60, respectively. In conclusion, ATP-MgCl2 improved skin flap survival. We were able to assess the metabolic state of the ATP-MgCl2-perfused skin flap and found that PCr/Pi ratios correlated with flap survival.
三磷酸腺苷（ATP）水平降低被认为是皮瓣坏死的重要原因之一。本研究评估了动脉内灌注三磷酸腺苷 - 氯化镁（MgCl2）对大鼠缺血性神经血管皮岛瓣的有益作用，并使用磷31 - （P31）磁共振波谱（MRS）观察了高能磷酸代谢物的变化。通过P31 MRS观察三磷酸腺苷（ATP）、磷酸肌酸（PCr）和无机磷酸盐（Pi）的变化，并比较每种代谢物的比例。术后7天使用图像分析仪评估皮瓣存活范围。实验组（ATP - MgCl2）的PCr/Pi比值与对照组（平衡盐溶液）有显著差异（p < 0.05）。此外，与对照组（14.2%）相比，灌注ATP - MgCl2显著提高了皮瓣存活面积（40.3%；p < 0.05）。PCr/Pi、PCr/（PCr + Pi）比值与皮瓣存活范围相关，相关系数分别为0.59和0.60。总之，ATP - MgCl2改善了皮瓣存活。我们能够评估灌注ATP - MgCl2的皮瓣的代谢状态，并发现PCr/Pi比值与皮瓣存活相关。
