Marin P C, Im M J, Girotto J A, Borschel G, Bickel K D
Division of Plastic, Reconstructive and Maxillofacial Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
J Reconstr Microsurg. 1998 Oct;14(7):485-90. doi: 10.1055/s-2007-1000211.
The authors have demonstrated previously that pretreatment with deferoxamine, an iron chelator and antioxidant, at the time of release in acute nerve compression, provided protection against ischemia/reperfusion (I/R) injury. In the present study, they evaluated whether therapeutic intervention with hydroxyethyl-starch-bound deferoxamine (HES-DFO) at the time of release of the chronically-compressed peripheral nerve protects the nerve from I/R injury. The sciatic nerves of 43 male Sprague-Dawley rats, weighing 325 to 350 g, were subjected to 8 weeks of compression with Silastic tubing. The treatment group received intravenous HES-DFO (70 mg/kg) at the time of decompression, while the control group received an equal volume of intravenous hetastarch vehicle at the same time schedule and route. Nerve-tissue samples from the compression site, as well as contralateral noncompressed nerves, were assayed for malondialdehyde (MDA), a marker of I/R injury. The control group exhibited MDA levels up to five times normal, and did not return to normal for 21 days. In contrast, the HES-DFO group had MDA levels that were not statistically significantly different from normal levels. The results confirm that pretreatment with HES-DFO prior to the surgical decompression of chronically-compressed nerve provides marked protection against I/R injury.
作者们之前已经证明,在急性神经受压解除时,用铁螯合剂及抗氧化剂去铁胺进行预处理,可预防缺血/再灌注(I/R)损伤。在本研究中,他们评估了在慢性受压的周围神经解除压迫时,用羟乙基淀粉结合去铁胺(HES-DFO)进行治疗性干预是否能保护神经免受I/R损伤。对43只体重325至350克的雄性Sprague-Dawley大鼠的坐骨神经,用硅橡胶管进行8周的压迫。治疗组在减压时静脉注射HES-DFO(70毫克/千克),而对照组在相同时间安排和途径下接受等量的静脉注射羟乙基淀粉赋形剂。对来自压迫部位以及对侧未受压神经的神经组织样本进行丙二醛(MDA)检测,MDA是I/R损伤的标志物。对照组的MDA水平高达正常水平的五倍,且在21天内未恢复正常。相比之下,HES-DFO组的MDA水平与正常水平无统计学显著差异。结果证实,在对慢性受压神经进行手术减压之前,用HES-DFO进行预处理可显著预防I/R损伤。