术中预缺血对猪骨骼肌保护作用的实验研究

目的研究术中预缺血对骨骼肌缺血坏死的保护作用及相关的肌肉代谢变化。方法 10只猪背阔肌瓣在4h 缺血前先进行3个循环10min 的术中预缺血,48h 后用染色法记录肌肉成活率,于肌肉缺血前、缺血后2,4h 和再灌流1.5h 分别作肌肉活检。结果 4h 缺血后的肌瓣,术中预缺血组成活率高出对照组44％,肌肉活检三磷酸腺苷(ATP)增加和乳酸降低(P<0.05)。结论术中预缺血可增加骨骼肌对缺血坏死的保护作用,这与肌肉中能量代谢的减低相关。

Acute ischemic preconditioning protects against skeletal muscle infarction in the pig

Objective The aim of this study was to investigate metabolism of ischemic muscle and the efficacy of acute ischemic preconditioning for protection of skeletal muscles against infarction. Methods The efficacy of preconditioning was tested by subjecting pig latissimus dorsi muscle to 3 cycles of ischemia reperfusion,each for 10 min,before 4 h of global ischemia.Infarction was assessed at 48 h reperfusion using nitroblue tetrazolium dye.Muscle biopsies were taken from the latissimus dorsi before is- chemia,at the end of 2 and 4 h of ischemia and 1.5 h of reperfusion.Results Preconditioning reduced the total infarct size by 44% in the latissimus dorsi.The muscle contents of ATP were maintained higher and the lactate lower (P<0.05) in the preconditioned than in the non-preconditioned muscle at the end of 2 h,4 h of ischemia and 1.5 h of reperfusion.Conclusion Preconditioning of pig skeletal muscle is as- sociated with a lower energy metabolism during sustained ischemia.At the present time,it is not known if this energy sparing effect is a major mechanism of ischemia preconditioning against infarction in the skele- tal muscle.