Gradual reperfusion reduces infarct size and endothelial injury but augments neutrophil accumulation.
Gradual reperfusion reduces infarct size and endothelial injury but augments neutrophil accumulation.
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逐渐再灌注可减少梗塞面积和内皮损伤，但会增加中性粒细胞的积累。
DOI：
10.1016/s0003-4975(97)00734-0
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发表时间：
1997
期刊：
影响因子：
--
通讯作者：
Vinten-Johansen,J
中科院分区：
文献类型：
--
作者：
Sato,H;Jordan,JE;Zhao,ZQ;Sarvotham,SS;Vinten-Johansen,J
背景再灌流主要通过中性粒细胞介导的机制对冠状动脉内皮细胞造成损伤。然而，中性粒细胞以外的其他因素可能控制心肌坏死的程度。本研究验证了逐渐启动复流可以减轻再灌注损伤和保护缺血后内皮功能的假说。方法在16只麻醉犬上，结扎左前降支60min。在一组，再灌流是突然开始的(n=8)，而在逐渐再灌注组(n=8)，血流在再灌流的前30分钟缓慢开始。结果急变组心肌梗死面积(坏死面积/危险面积)(28.2%±2.0%)明显小于急变组(41.6%±1.4%)。中性粒细胞在危险区域的积聚(髓过氧化物酶)在斜坡组显著高于急性组(8.0±1.3和3.5±0.8U/g组织)。在单独的缺血后左前降支动脉环上，引起最大可能反应50%的乙酰胆碱浓度(−6.88±0.04log[−/L])显著高于RAMP(−7.62±0.04log[moL/L])和对照组(−7.68±0.003 log[mo1/L])，提示内皮功能障碍。A23187对最大可能反应的50%反应浓度在突变组(−7.24±0.03log[m ol/L])高于斜坡组(−7.62±0.03log[m ol/L])和对照组(−7.8±0.04log[m ol/L])。结论缺血区的渐进性再灌流缩小了梗塞面积，保护了内皮功能，但却矛盾地增加了危险区域内中性粒细胞的聚集。
BackgroundReperfusion causes injury to the coronary artery endothelium primarily by neutrophil-mediated mechanisms. However, factors other than neutrophils may govern the extent of myocardial necrosis. This study tests the hypothesis that gradual initiation of reflow will reduce reperfusion injury and preserve postischemic endothelial function.MethodsIn 16 anesthetized dogs, the left anterior descending artery was ligated for 60 minutes. In one group, reperfusion was initiated abruptly (abrupt, n = 8), whereas in the gradual reperfusion group (ramp, n = 8), flow was slowly initiated during the first 30 minutes of reperfusion. After reperfusion, coronary artery segments were isolated to assess postischemic endothelial function.ResultsInfarct size (area of necrosis/area at risk) was significantly reduced in the ramp group (28.2% ± 2.0%) compared with abrupt (41.6% ± 1.4%). Neutrophil accumulation (myeloperoxidase) in the area at risk was significantly greater in the ramp group compared with abrupt (8.0 ± 1.3 versus 3.5 ± 0.8 U/g tissue). In isolated postischemic left anterior descending arterial rings, the concentration of acetylcholine that elicited a response 50% of the maximum possible response was significantly greater in abrupt (−6.88 ± 0.04 log [mol/L]) than ramp (−7.62 ± 0.04 log [mol/L]) and control (−7.68 ± 0.003 log [mol/L]), suggesting endothelial dysfunction. The concentration of A23187 that elicited a response 50% of the maximum possible response was similarly greater in abrupt (−7.24 ± 0.03 log [mol/L]) versus ramp (−7.62 ± 0.03 log [mol/L]) and control (−7.8 ± 0.04 log [mol/L]). Smooth muscle dysfunction (response to sodium nitrite) also occurred in the abrupt rings.ConclusionsGradual reperfusion of an ischemic area reduces infarct size and preserves endothelial function but paradoxically increases neutrophil accumulation within the area at risk.
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缺血后控制再灌注的研究。
DOI：
10.1016/s0022-5223(19)35470-4
发表时间：
1986
期刊：
The Journal of thoracic and cardiovascular surgery
影响因子：
--
作者：
C. Acar;M. Partington;G. Buckberg
通讯作者：
G. Buckberg
使用一氧化氮供体 SPM-5185 增强血液停跳液可抵消缺血后内皮和心室功能障碍。
DOI：
10.1016/s0022-5223(95)70198-2
发表时间：
1995
期刊：
The Journal of thoracic and cardiovascular surgery.
影响因子：
--
作者：
Nakanishi,K;Zhao,ZQ;Vinten-Johansen,J;Hudspeth,DA;McGee,DS;HammonJr,JW
通讯作者：
HammonJr,JW
心脏手术期间的心肌保护。
影响因子：
10.5
作者：
B. Reitz
通讯作者：
B. Reitz
局部缺血后手术再灌注与药物再灌注的优越性。
DOI：
--
发表时间：
1986
期刊：
The Journal of thoracic and cardiovascular surgery
影响因子：
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作者：
Vinten-Johansen,J;Buckberg,GD;Okamoto,F;Rosenkranz,ER;Bugyi,H;Leaf,J
通讯作者：
Leaf,J