蝮蛇抗栓酶对骨骼肌缺血再灌注损伤保护的实验研究

Experimental research on the protective effect of agkistrodon halys antithrombin on ischemical reperfusion injury of skeletal muscles

目的 探讨骨骼肌缺血再灌注损伤前后微循环变化及蝮蛇抗栓酶(Svate)的保护作用。方法24只新西兰大白兔随机分成实验组和对照组,以气囊止血带造成兔左下肢缺血再灌注损伤模型。实验组分别在缺血前及再灌注前给予Svate 静注,对照组给予等量生理盐水。用活体微循环显微镜观察兔缺血前及再灌注后骨骼肌微循环的变化并作血液流变学检测。结果 骨骼肌缺血再灌注后对照组:全血粘度增高、血流缓慢、红细胞严重聚集、纤维蛋白原增加,大量白细胞附壁和白色微栓形成,无复流现象严重,微血管有渗出、渗血,骨骼肌组织损伤较重。随再灌注时间的推移,微循环障碍逐渐加重;实验组经Svate保护,血液流变学状况、微循环障碍明显好转,骨骼肌组织损伤较轻。结论①骨骼肌缺血再灌注后造成严重的微循环障碍和肌组织损伤;②Svate通过疏通微循环对骨骼肌缺血再灌注损伤起保护作用。

Objective To explore the changes of microcirculation and hemorrheology on ischemia reper-fusion injury of skeletal muscles and evaluate the protective effects of Agkistrodon halys anti-thrombin(Svate) Methods 24 New Zealand rabbits were divided randomly into experimental group and the control. The model of ischemia reperfusion injury of skeletal muscles was built by tourniquet. The anti-thrombin Svate was applicated in experimental group instead of saline in control group before ischemia and reperfusion. The changes of micro-circulation were observed. Results After 4hrs ischemia and 2hrs reperfusion of skeletal muscles in control group: the whole blood viscosity, severe erythrocyte aggregation index and fibrinogen were significantly increased, blood flow slowed down. Serious no-reflow phenomenon, erythrocyte aggregation, large amounts of neutrophil-endothelial adhesion and white micro-thrombosis were obsered in microcirculation of the control group,There was exudation and oozing of blood from capillaries,and the more severe damages of skeleton muscles. The disturbance of micro-circulation would be gradually aggravated along with the increase time of reperfusion. In experimental group: the condition of heamo-dynamics and microcirculatory disturbances were improved and the damages of the skeletal muscles was lighter. Conclusion (1) Seriously microcirculatory disturbance cause by ischemia reperfusion injury of skeletal muscles. (2)Anti-thrombin Svate could play the impotant roles in prevention from ischemia reperfusion injury of skeletal muscles by dredging microcirculation.