Benz S, Schnabel R, Weber H, Pfeffer F, Wiesner R, von Breitenbuch P, Nizze H, Schareck W, Hopt U T
Department of Surgery, University of Rostock, Germany.
Transplantation. 1998 Oct 27;66(8):994-9. doi: 10.1097/00007890-199810270-00005.
The role of nitric oxide in the ischemia/reperfusion injury of the pancreas is still unclear. In other organs, protective as well as aggravating effects have been described. We have, therefore, investigated the effect of the nitric oxide donor sodium nitroprusside on pancreatic ischemia/reperfusion injury.
In Landrace pigs, after transsection of the pancreas, complete vascular isolation of the pancreatic tail was performed. The tail was subjected to 3 hr of warm ischemia and thereafter reperfusion (6 hr). The animals were divided into a control group (n=7) and a treatment group (n=7) that received 15 mg of sodium nitroprusside after reperfusion intra-arterially into the splenic artery.
The morphological tissue damage and lipase activity in the venous effluent of the pancreas were significantly lower in the treatment group. Partial oxygen tension in the tissue after reperfusion was markedly reduced in the control group, indicating an impairment of microcirculation. In the treatment group, however, partial oxygen tension in the tissue was significantly higher (43 vs. 20 mmHg; P<0.014). Furthermore, total blood flow through the pancreatic tail in the treatment group was found to be significantly higher in the late reperfusion period (14 vs. 9.5 ml/min at 5 hr after reperfusion; P<0.05).
There is a marked impairment of pancreatic microcirculation after reperfusion. Sodium nitroprusside counteracts this impairment and has a protective effect on ischemia/reperfusion injury of the pancreas.
一氧化氮在胰腺缺血/再灌注损伤中的作用仍不清楚。在其他器官中,已描述了其保护作用和加重作用。因此,我们研究了一氧化氮供体硝普钠对胰腺缺血/再灌注损伤的影响。
在长白猪中,横断胰腺后,对胰尾进行完全血管隔离。胰尾经历3小时的热缺血,然后再灌注(6小时)。动物被分为对照组(n = 7)和治疗组(n = 7),治疗组在再灌注后经脾动脉动脉内给予15 mg硝普钠。
治疗组胰腺静脉流出液中的形态学组织损伤和脂肪酶活性显著降低。对照组再灌注后组织中的局部氧张力明显降低,表明微循环受损。然而,治疗组组织中的局部氧张力显著更高(43对20 mmHg;P<0.014)。此外,发现治疗组在再灌注后期通过胰尾的总血流量显著更高(再灌注后5小时为14对9.5 ml/min;P<0.05)。
再灌注后胰腺微循环存在明显损伤。硝普钠可抵消这种损伤,并对胰腺缺血/再灌注损伤具有保护作用。