目的 探討阿霉素預(yù)處理提供鼠皮瓣缺血耐受的可能性及其作用機(jī)制。 方法健康成年SD大鼠24只，雌雄各半，體重250～300 g，隨機(jī)分為A、B、C 3組（n=8）。于各組大鼠腹部制備以腹壁淺血管-神經(jīng)束為蒂、大小為6 cm × 3 cm的島狀皮瓣，A組不作處理；B組用微血管夾阻斷腹壁淺血管血流10 min，松開(kāi)后再灌注10 min，反復(fù)4次；C組經(jīng)腹壁淺靜脈推注阿霉素（1 mg/kg）。24 h后于皮瓣蒂部夾閉腹壁淺血管4 h，再灌注2 h，制備缺血再灌注損傷模型。術(shù)后觀察大鼠存活情況，于缺血再灌注損傷后0、8、12、24、30 h各組取皮瓣檢測(cè)丙二醛（malonyldiadehyde，MDA）和超氧化物歧化酶（superoxide dismutase，SOD）含量；于缺血再灌注損傷后7 d測(cè)量皮瓣成活率后處死大鼠，取皮瓣行組織學(xué)觀察。 結(jié)果實(shí)驗(yàn)中共5只大鼠死亡，其中A、B組各1只，C組3只，均給予補(bǔ)充。缺血再灌注損傷后7 d，A組皮瓣成活率為10.10% ± 0.43%，小于B組91.63% ± 1.76%及C組92.75% ± 1.48%，差異均有統(tǒng)計(jì)學(xué)意義（P lt; 0.05）；B組與C組比較，差異無(wú)統(tǒng)計(jì)學(xué)意義（t=0.29，P=0.77）。缺血再灌注損傷后0 h 3組間MDA和SOD含量比較，差異均無(wú)統(tǒng)計(jì)學(xué)意義（P gt; 0.05）；8 h后各時(shí)間點(diǎn)A組與B、C組比較，差異均有統(tǒng)計(jì)學(xué)意義（P lt; 0.05），B組與C組比較差異無(wú)統(tǒng)計(jì)學(xué)意義（P gt; 0.05）。組織學(xué)觀察示，A組炎性細(xì)胞浸潤(rùn)較B、C組明顯，纖維增生減弱；B組與C組皮瓣組織學(xué)改變相似。 結(jié)論阿霉素預(yù)處理可以提供鼠皮瓣缺血耐受，保護(hù)皮瓣減輕缺血再灌注損傷，其機(jī)制可能與誘導(dǎo)內(nèi)源性保護(hù)物質(zhì)的產(chǎn)生有關(guān)。
引用本文： 李虹,岑瑛,張振宇. 阿霉素預(yù)處理替代缺血預(yù)處理提供鼠皮瓣缺血耐受的實(shí)驗(yàn)研究. 中國(guó)修復(fù)重建外科雜志, 2012, 26(12): 1501-1504. doi: 復(fù)制
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| 1. | 朱飛, 寧金龍, 展望, 等. 缺血預(yù)處理對(duì)肌皮瓣缺血再灌注損傷的保護(hù)作用. 中華顯微外科雜志, 1999, 22(4): 288-289. |
| 2. | Hellström PM. Vagotomy inhibits the effect of neurotensin on gastrointestinal transit in the rat. Acta Physiol Scand, 1986, 128(1): 47-55. |
| 3. | Murry CE, Jennings RB, Reimer RA. Preconditiony with ischemia: a delay of lethal cell injury in ischemic myocardium. Circulation, 1986, 74(5): 1124-1136. |
| 4. | 吳剛, 劉永鋒, 楊蕾, 等. 阿霉素預(yù)處理替代缺血預(yù)處理提供鼠肝缺血耐受力的實(shí)驗(yàn)研究. 中華肝膽外科雜志, 2002, 8(5): 297-299. |
| 5. | Manson GF, Murphy GF, Anthenelli RM, et al. The role of oxygen-free radicals in ischemia tissue injury in island skin flaps. Ann Surg, 1983, 198(1): 87-90. |
| 6. | Dana A, Baxter GF, Yellon DM. Delayed or second window preconditioning induced by adenosine A1 receptor activation is inpendent of early generation of nitric oxide or late induction of inducible nitrix oxide synthase. J Cardiovasc Pharmacol, 2001, 38(2): 278-287. |
| 7. | 吳升華, 楊運(yùn)昌, 王兆銘. 阿霉素心臟毒性中脂質(zhì)過(guò)氧化的研究. 中國(guó)抗生素雜志, 1989, 14(5): 349-354. |
| 8. | 吳立春, 陳國(guó)楨, 方中良. 熱休克蛋白與心肌缺血預(yù)適應(yīng)延遲保護(hù)作用的關(guān)系. 醫(yī)學(xué)綜述, 2008, 8(15): 2252-2254. |
| 9. | 屈新才, 王繼亮, 秦濤, 等. 供肝缺血預(yù)處理對(duì)大鼠肝移植缺血再灌注損傷的保護(hù)性作用. 中國(guó)普通外科雜志, 2007, 16(3): 240-244. |
| 10. | 汪曉筠, 謝智, 王建新, 等. 熱休克聯(lián)合缺血預(yù)處理對(duì)大鼠心肌缺血再灌注損傷早期的保護(hù)作用研究. 實(shí)用醫(yī)學(xué)雜志, 2012, 28(5): 711-714. |
| 11. | 徐久宏, 張三典, 高耀明, 等. 阿霉素對(duì)心肌細(xì)胞損傷的實(shí)驗(yàn)研究. 蘇州大學(xué)學(xué)報(bào): 醫(yī)學(xué)版, 2008, 28(1): 47-49. |
| 12. | Tokarska-Schlattner M, Wallimann T, Schlattner U. Alterations in myocardial energy metabolism induced by the anti-cancer drug doxorubicin. C R Biol, 2006, 329(9): 657-668. |
| 13. | Mishra S, Murphy LC, Murphy TJ. The Prohibitins: emerging roles in diverse functions. J Cell Mol Med, 2006, 10(2): 353-363. |
| 14. | Wood ZA, Schröder E, Robin HJ, et al. Structure, mechanism and regulation of peroxiredoxins. Trends Biochem Sci, 2003, 28(1): 32-40. |
| 15. | Imura H, Caputo M, Lim K, et al. Pulmonary injury after cardiopulmonary bypass: beneficial effects of low-frequency mechanical ventilation. J Thorac Cardiovasc Surg, 2009, 137(6): 1530-1537. |
| 16. | Barrier A, Olaya N, Chiappini F, et al. Ischemic preconditioning modulates the expression of several genes, leading to the overproduction of IL-1Ra, iNOS, and Bcl-2 in a human model of liver ischemia- reperfusion. FASEB J, 2005, 19(12): 1617-1626. |
- 1. 朱飛, 寧金龍, 展望, 等. 缺血預(yù)處理對(duì)肌皮瓣缺血再灌注損傷的保護(hù)作用. 中華顯微外科雜志, 1999, 22(4): 288-289.
- 2. Hellström PM. Vagotomy inhibits the effect of neurotensin on gastrointestinal transit in the rat. Acta Physiol Scand, 1986, 128(1): 47-55.
- 3. Murry CE, Jennings RB, Reimer RA. Preconditiony with ischemia: a delay of lethal cell injury in ischemic myocardium. Circulation, 1986, 74(5): 1124-1136.
- 4. 吳剛, 劉永鋒, 楊蕾, 等. 阿霉素預(yù)處理替代缺血預(yù)處理提供鼠肝缺血耐受力的實(shí)驗(yàn)研究. 中華肝膽外科雜志, 2002, 8(5): 297-299.
- 5. Manson GF, Murphy GF, Anthenelli RM, et al. The role of oxygen-free radicals in ischemia tissue injury in island skin flaps. Ann Surg, 1983, 198(1): 87-90.
- 6. Dana A, Baxter GF, Yellon DM. Delayed or second window preconditioning induced by adenosine A1 receptor activation is inpendent of early generation of nitric oxide or late induction of inducible nitrix oxide synthase. J Cardiovasc Pharmacol, 2001, 38(2): 278-287.
- 7. 吳升華, 楊運(yùn)昌, 王兆銘. 阿霉素心臟毒性中脂質(zhì)過(guò)氧化的研究. 中國(guó)抗生素雜志, 1989, 14(5): 349-354.
- 8. 吳立春, 陳國(guó)楨, 方中良. 熱休克蛋白與心肌缺血預(yù)適應(yīng)延遲保護(hù)作用的關(guān)系. 醫(yī)學(xué)綜述, 2008, 8(15): 2252-2254.
- 9. 屈新才, 王繼亮, 秦濤, 等. 供肝缺血預(yù)處理對(duì)大鼠肝移植缺血再灌注損傷的保護(hù)性作用. 中國(guó)普通外科雜志, 2007, 16(3): 240-244.
- 10. 汪曉筠, 謝智, 王建新, 等. 熱休克聯(lián)合缺血預(yù)處理對(duì)大鼠心肌缺血再灌注損傷早期的保護(hù)作用研究. 實(shí)用醫(yī)學(xué)雜志, 2012, 28(5): 711-714.
- 11. 徐久宏, 張三典, 高耀明, 等. 阿霉素對(duì)心肌細(xì)胞損傷的實(shí)驗(yàn)研究. 蘇州大學(xué)學(xué)報(bào): 醫(yī)學(xué)版, 2008, 28(1): 47-49.
- 12. Tokarska-Schlattner M, Wallimann T, Schlattner U. Alterations in myocardial energy metabolism induced by the anti-cancer drug doxorubicin. C R Biol, 2006, 329(9): 657-668.
- 13. Mishra S, Murphy LC, Murphy TJ. The Prohibitins: emerging roles in diverse functions. J Cell Mol Med, 2006, 10(2): 353-363.
- 14. Wood ZA, Schröder E, Robin HJ, et al. Structure, mechanism and regulation of peroxiredoxins. Trends Biochem Sci, 2003, 28(1): 32-40.
- 15. Imura H, Caputo M, Lim K, et al. Pulmonary injury after cardiopulmonary bypass: beneficial effects of low-frequency mechanical ventilation. J Thorac Cardiovasc Surg, 2009, 137(6): 1530-1537.
- 16. Barrier A, Olaya N, Chiappini F, et al. Ischemic preconditioning modulates the expression of several genes, leading to the overproduction of IL-1Ra, iNOS, and Bcl-2 in a human model of liver ischemia- reperfusion. FASEB J, 2005, 19(12): 1617-1626.