依达拉奉对断肢再植后肢体的保护作用

Prophylactic effects of edaravone on the extremity after limb replantation

背景:怎样减轻断肢再植后缺血再灌注损伤的严重程度,目前尚无有效方法。目的:探讨依达拉奉能否对断肢再植术后肢体起到保护作用。方法:根据不同的干预方法,将18只健康兔随机数字表法均分为3组(n=6),分别为依达拉奉组、缺血再灌注组和空白对照组。建立左下肢的离断肢体模型,其中,依达拉奉组于再灌注前给予以依达拉奉为主的灌注液进行灌注(1.5 mg/kg),分别于2,4,8,12 h于兔的胫骨前肌取材,分别测定骨骼肌超氧化物歧化酶、髓过氧化物酶、丙二醛、Ca2+-ATP酶、Na+-K+-ATP酶,湿质量/干质量比值,光镜下观察骨骼肌结构的病理变化。结果与结论:缺血再灌注后兔骨骼肌的肌纤维水肿,损伤明显,大量炎性细胞浸润,依达拉奉干预后损伤程度减轻,但均随时间增加而加剧。依达拉奉能够明显提高缺血再灌注后机体内超氧化物歧化酶、过氧化物酶、Na+-K+-ATP酶、Ca2+-ATP酶含量,降低丙二醛、湿质量/干质量比值,各项指标差异均存在显著性意义(P<0.05),可见依达拉奉对断肢再植后肢体有着明显的保护作用。依达拉奉为主的混合灌注液能够有效地预防再植后肢体(特别是骨骼肌)的缺血再灌注损伤。

BACKGROUND： At present, there is no effective method to attenuate the severity of ischemia/reperfusion injury after limb replantation. OBJECTIVE： To investigate the prophylactic effects of edaravone solution on extremity after limb replantation. METHODS： According to different interventions, 18 healthy rabbits were randomly divided into three groups （n=6） edaravone group, control group and ischemia/reperfusion injury group. The replantation models in the left hindlimbs were established. In edaravone group, rabbits were perfused with edaravone solution （1.5 mg/kg） before the reperfusion. At 2, 4, 8, 12 hours, the tibialis anterior muscles tissues of rabbits were harvested, and the following levels were determined, including superoxide dismutase, myeloperoxidase, malondialdehyde, Ca2＋-ATPase, Na＊-K-ATPase, wet weight/dry weight ratio. The morphology of tibialis anterior muscles was observed under light microscope. RESULTS AND CONCLUSION： After ischemia and reperfusion, the skeletal muscle fibers appeared edema and apparent damage, a large number of inflammatory cells infiltrated. After the intervention of edaravone solution, the damage was attenuated, but aggravated along the time. Edaravone solution significantly increased the level of superoxide dismutase, myeloperoxidase, Ca2＊-ATPase, Na＊-K＊-ATPase, and significantly decreased the levelof malondialdehyde and wet weight/dry weight ratio （P 〈 0.05）. Edaravone solution exerts apparent protective effects on extremity after limb replantation, and can improve the ischemia/reperfusion injury in the extremity （especially skeletal muscle） after limb replantation.