灯盏花在肢体缺血再灌注致远隔多器官损伤的预防作用

Distant multiple organ dysfunction caused by hind limb ischemia/reperfusion and preventive effect of breviscapine

目的 观察肢体缺血再灌注致远隔多器官损伤及灯盏花的预防作用。方法 实验共分 3组 :①再灌注组 :夹闭大鼠双侧股动脉 ,阻断循环 2h再灌注 5h ,建立双下肢缺血再灌注模型 ;②灯盏花组 :每日腹腔注射云南灯盏花注射液 1ml,共 7d ,后按再灌注组方法制作模型 ;③对照组 :行假手术处理。观察大鼠下肢骨骼肌、远隔器官胃、肾、肺、肝及脑组织超微病理改变、测定心肌酶、肝酶改变、红细胞超氧化物歧化酶 (SOD)含量、组织丙二醛(MDA)含量、血清谷胱甘肽 (GSH)含量 ,观察灯盏花对远隔器官损伤的预防作用和对以上指标的影响。结果 再灌注组骨骼肌病变较其单纯缺血时严重 ,远隔器官肝、肺、肾、胃及脑有弥漫性损伤 ;心肌酶、肝酶较对照组显著增高 (P <0 .0 5 ) ;红细胞SOD及血清GSH较对照组显著下降 (P <0 .0 5 ) ;肝、肺组织匀浆MDA含量则显著增多(P <0 .0 5 ) ;灯盏花组病变较对照组明显改善。结论 肢体缺血再灌注不但使再灌注器官本身损伤加重 ,还可引起远隔多器官损伤 ,灯盏花作为强抗氧化剂 。

Objective To observe the pathogenesis of distant multiple organ dysfunction caused by hind limb ischemia /reperfusion and the preventive effect of breviscapine. Methods Wistar rats were divided into 3 groups: ① Reperfusion group: rats underwent 2 hour bilateral femoral artery occlusion of hind limb to produce ischemia followed by 5 hour reperfusion.② Breviscapine group: rats received intraperitoneal injection of breviscapine 1 ml every day for 7 days and underwent 2 hour ischemia of hind limb followed by 5 hour reperfusion. ③ Control group: animals underwent sham operation. Ultrastructural pathological changes in the limb muscles after ischemia for 2h, reperfusion for 5h and the distant organs such as the lung, liver, kidney, stomach, brain after reperfusion for 5h were studied.Myocardial and liver enzymes were measured. Superoxide dismutase (SOD) of erythrocyte, malondialdehyde (MDA) in tissues and glutathione (GSH) in serum were assayed. Results It was showed that the muscles of hind limb after reperfusion for 5h were damaged more severely than those after ischemia for 2h. In reperfusion group, extensive injury of remote multiple organs such as the lung, kidney, stomach and brain occurred;Myocardial and liver enzymes were also significantly increased ( P<0.05 );SOD of erythrocyte and GSH in serum were decreased as compared with control group ( P< 0.05); while MDA in tissue homogenates of liver and lung was significantly increased(P< 0.05 ).The pathological changes in breviscapine group were obviously alleviated.Conclusions Hind limb ischemia/reperfusion can not only result in local tissue damage, but also cause dysfunction of remote multiple organs. Breviscapine as a powerful antioxidant can alleviate the pathological changes in remote organ dysfunction caused by hind limb ischemia /reperfusion.