骨骼肌缺血再灌注损伤后的血液流变性及微循环变化

Changes of Hemorheology and Microcirculation on Ischemia and Reperfusion Injury of Skeletal Muscles in Rabbits

目的：探讨骨骼肌缺血再灌注损伤与血液流变性、肌肉微循环障碍的关系。方法：在兔大腿上止血带制成骨骼肌缺血再灌注损伤模型，观察损伤前后兔左趾长伸肌腱系膜表面微循环状况并检测血液流变学指标。结果：骨骼肌缺血再灌注后全血粘度、红细胞聚集指数、红细胞电泳时间均高于缺血前；微循环出现红细胞聚集、血流缓慢、白细胞附壁、白色微栓形成，且无复流现象严重。结论：全血粘度增高、红细胞聚集、白色微栓形成及无复流现象等微循环障碍是骨骼肌缺血再灌注损伤发生、发展的重要机制之一。

Twelve New Zealand rabbits were selected and the model of ischemia and reperfusion injury was caused by blocking the blood flow of its left hind limb with a pneumatic tourniquet(40 kPa). The changes of hemorheology and microcirculation were observed before and after reperfusion injury. Result: after four hours ischemia and two hours reperfusion of skeletal muscles, blood viscosity(low shear rate), red blood cell electrophores time, and red blood cell aggregation index were significantly higher, plasma viscosity decreased, hematocrit had no change, pathologic changes such as red cell aggregation, permeability of microvessels increase, blood flow slowed down, no reflow phenomenon and white thrombosis were observed in microcirculation after ischemia and reperfusion injury. Conclusion: Hemorheological changes and microcirculation disturbance were important causes leading ischemia and reperfusion injury of skeletal muscles.