Woitaske M D, McCarter R J
Department of Physiology, University of Texas Health Science Center at San Antonio, USA.
Plast Reconstr Surg. 1998 Nov;102(6):2052-63. doi: 10.1097/00006534-199811000-00037.
Tourniquets frequently used during surgery involve tissue ischemia followed by postoperative reperfusion. However, little information is available on the functional consequences of this procedure in skeletal muscle. The goal of this study was to use skeletal muscles of C57BL/6 adult male mice to assess functional, structural, and biochemical characteristics after hindlimb vessel occlusion. Experimental manipulation involved application of a tourniquet to the hindlimb for a 3-hour period (n = 65). Muscles were then excised after various periods of reperfusion. Soleus and extensor digitorum longus muscles were chosen as representative of slow oxidative and fast glycolytic muscle fiber types, respectively. The most striking functional change found after ischemia-reperfusion injury was markedly improved endurance of extensor digitorum longus muscles. These fast-twitch glycolytic muscle fibers became much more resistant to fatigue during recovery from ischemia-reperfusion injury. There was a progressive increase in force generation in both muscles during recovery; however, soleus muscles recovered function more quickly after ischemia-reperfusion than extensor digitorum longus muscles. Also, extensor digitorum longus muscles recovered mass more slowly than soleus muscles at 7 and 14 days after ischemia. Structurally, extensor digitorum longus muscles had more severely damaged mitochondria, sarcoplasmic reticulum, and myofibrils. Surprisingly, no differences in oxidative enzyme activity (citrate synthase) and oxidative damage (in protein and lipids) were found after ischemia-reperfusion. The results indicate that muscle fiber type has a significant impact on the nature of ischemia-reperfusion injury in skeletal muscle. Thus, muscle fiber composition would be expected to affect recovery from the clinical use of tourniquets and other ischemic procedures. Furthermore, the results suggest that damage to structures involved in energy transduction and excitation-contraction coupling may play a role in the effects.
手术中经常使用的止血带会导致组织缺血,随后是术后再灌注。然而,关于该操作对骨骼肌功能影响的信息却很少。本研究的目的是利用C57BL/6成年雄性小鼠的骨骼肌来评估后肢血管闭塞后的功能、结构和生化特征。实验操作包括在后肢使用止血带3小时(n = 65)。然后在不同的再灌注时间段后切除肌肉。分别选择比目鱼肌和趾长伸肌作为慢氧化型和快糖酵解型肌纤维类型的代表。缺血再灌注损伤后发现的最显著功能变化是趾长伸肌的耐力明显提高。这些快收缩糖酵解型肌纤维在从缺血再灌注损伤恢复过程中对疲劳的抵抗力大大增强。在恢复过程中,两块肌肉的力量产生都有逐渐增加;然而,比目鱼肌在缺血再灌注后比趾长伸肌更快恢复功能。此外,在缺血后7天和14天,趾长伸肌的质量恢复比目鱼肌更慢。在结构上,趾长伸肌的线粒体、肌浆网和肌原纤维受损更严重。令人惊讶的是,缺血再灌注后氧化酶活性(柠檬酸合酶)和氧化损伤(蛋白质和脂质方面)没有差异。结果表明,肌纤维类型对骨骼肌缺血再灌注损伤的性质有显著影响。因此,预计肌纤维组成会影响止血带及其他缺血操作临床应用后的恢复情况。此外,结果表明参与能量转导和兴奋 - 收缩偶联的结构损伤可能在这些影响中起作用。