主动脉转流对内脏缺血再灌注损伤的影响

Impact of Aortic Bypass on Viscera Ischemia reperfusion Injury

目的:探讨不同流量主动脉转流对腹主动脉暂时性阻断所引起肝、肾和小肠等内脏缺血再灌注损伤的影响。方法:实验建立在小猪腹腔动脉开口以上阻断腹主动脉1h和同时辅助主动脉转流的模型,检测在不同再灌注时点肝、肾、小肠组织及血液中丙二醛(MDA)和超氧化物歧化酶(SOD)的变化,同时检测主要肝肾功能、动脉血气分析。结果:50%流量组的血和组织中MDA含量和SOD的活性在几个再灌注时点与同组的缺血前比较差异有显著性,且在再灌注2h时BUN、pH和HCO-3的值与缺血前比较差异有显著性。70%流量组上述指标的改变较50%流量组有改善。结论:当主动脉转流量达到原腹主动脉流量的70%时主动脉转流这一措施能较好地预防腹主动脉阻断1h对肝、肾和小肠的缺血再灌注损伤。

Objective: To investigate the impact of aortic bypass of various flow on ischemia reperfusion injury in the liver, kidney and intestine caused by abdominal aorta temporary occlusion. Methods: A pig visceral ischemic model was established by cross clamping of the abdominal aorta above the celiac artery for 1 hour, and aortic bypass was used at the same time. The changes of SOD( superoxide dismutase) and MDA(malondialdehyde) in the liver, kidney and intestinal tissue and the blood were studied at different ischemia reperfusion period. Hepatic and renal functions and blood gas analysis were inspected. Results: The differences of the MDA levels and the activity of SOD in tissues and blood between several period of ischemic reperfusion and pre ischemia in 50% flow group were significant (P<0.05), and the differences of BUN , PH and HCO - 3 between 2 hours following reperfusion and pre ischemia were also remarkable. In 70% flow group, the aforementioned values improved significantly when comparing with that of 50% flow group. Conclusions: Ischemia reperfusion injuries of the liver, kidney and intestine could be well prevented when the flow of aortic bypass was up to 70% of the volume of abdominal aorta flow.