腹主动脉阻断导致内脏缺血再灌注损伤的研究

Study on abdominal viscera ischemia reperfusiion injury caused by abdominal aorta occlusion

目的观察腹主动脉阻断所引起的肝、肾、小肠等内脏缺血再灌注损伤的改变。方法建立小猪腹主动脉阻断１小时的模型，检测在不同再灌注时点组织及血液中丙二醛（ＭＤＡ）和超氧化物歧化酶（ＳＯＤ）的变化，同时检测肝肾功能和动脉血气分析，观察动物术后的生存情况。结果与缺血前比较，大多数再灌注时点血、组织中ＭＤＡ明显升高，而ＳＯＤ明显降低（Ｐ＜０．０５）。在再灌注２小时，血中谷丙转氨酶（ＡＬＴ）、尿素氮（ＢＵＮ）、肌酐（ＣＲＥ）较缺血前明显升高（Ｐ＜０．０１），代谢性酸中毒也极为明显。多数动物术后能够存活，但均出现下肢截瘫。结论腹主动脉阻断１小时能引起明显的内脏缺血再灌注损伤改变，多数内脏经处理后其损伤能够得到代偿恢复，而脊髓损伤恢复困难。

Objective\ To investigate the changes of ischemia reperfusion injury in the liver, kidney and intestine caused by abdominal aorta temporary occlusion. Methods\ A pig visceral ischemia model was established by abdominal aorta cross clamping above the celiac artery for 1h. The changes in superoxide dismutase (SOD) and malondialdehyde (MDA) in the liver, kidney and intestinal tissues and the blood were studied during the different ischemia reperfusion periods. Hepatic and renal functions and blood gas analysis were inspected, and the postoperative survival conditions of the animals were also studied.Results\ MDA levels in the tissues and blood were markedly increased, while the activity of SOD decreased ( P <0.05) during the period of ischemia reperfusion as compared with those before ischemia. At the 2nd h following the reperfusion, the levels of ALT, BUN and CRE in the blood were significantly higher than those of per ischemia ( P <0.01), and the animals also developed a serious metabolic acidosis. Most animals could survive after the operation, but paraplegia occurred in all animals.Conclusion\ Abdominal aorta occlusion had a marked impact on ischemia reperfusion injury of viscera. Injuries of most organs could restore if the period of occlusion was less than 1 h, but the restoration of spinal cord injury was very difficult.