DIFFERENTIAL RECOVERY OF SKELETAL-MUSCLE AND PERIPHERAL-NERVE FUNCTION AFTER ISCHEMIA AND REPERFUSION
DIFFERENTIAL RECOVERY OF SKELETAL-MUSCLE AND PERIPHERAL-NERVE FUNCTION AFTER ISCHEMIA AND REPERFUSION
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DOI：
10.1016/0022-4804(89)90041-3
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发表时间：
1989-07-01
影响因子：
2.2
通讯作者：
QUINONESBALDRICH, WJ
中科院分区：
文献类型：
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作者：
CHERVU, A;MOORE, WS;QUINONESBALDRICH, WJ
骨骼肌功能的恢复是急性缺血肢体血运重建的首要任务。为研究缺血再灌注对周围神经和骨骼肌功能的影响，在12只家兔中，通过暂时性动脉闭塞髂总动脉和股动脉并结扎侧支造成单侧后肢暂时性缺血（1或3小时）。对照肢体同样准备，不中断血流。两个胫骨前肌连接到力传感器，和抽搐和强直张力，在缺血间隔结束时和再灌注期间（2小时），通过直接肌肉刺激或刺激腓深神经。通过移除动脉夹和通过血管蒂上的多普勒血流记录的再灌注，使缺血肢体再灌注。缺血/再灌注肢体的肌肉功能相对于对侧对照肢体的恢复被用作恢复指标。到缺血间隔结束时，1小时或3小时组的神经刺激均未引起收缩活动。再灌注2小时后，1小时组恢复到0.558 ± 0.558。0.116（平均值±. SEM），而3小时组仅恢复了0.016 ± 0.016。控制功能0.005（P < 0.01）。与此相反，直接肌肉刺激，1小时组产生0.580 ±。0.015对比0.286 .+-. 0.042（P < 0.001）。再灌注2小时后，1小时组恢复了0.805 ± 0.001。0.059的肌肉功能，其显著优于0.580 ±。缺血3小时组为0.077（P < 0.05）。因此，周围神经比骨骼肌更容易受到缺血和短再灌注间隔的影响。在治疗急性严重缺血性肢体时可能证明有益的血运重建策略可能需要考虑相对较短时间缺血后周围神经功能的损伤。
Recovery of skeletal muscle function is of prime importance in revascularization of acutely ischemic extremities. In order to study the effect of ischemia and reperfusion on peripheral nerve and skeletal muscle function, temporary unilateral hindlimb ischemia (1 or 3 hr) was induced in 12 rabbits by temporary arterial occlusion of common iliac and femoral arteries and collateral ligation. The control limb was similarly prepared without interruption of blood flow. Both anterior tibialis muscles were attached to force transducers, and the twitch and tetanic tensions were measured at the end of the ischemic interval and during reperfusion (2 hr) by either direct muscle stimulation or stimulation of the deep peroneal nerve. The ischemic limb was reperfused by removal of arterial clamps and reperfusion documented by Doppler flow over the vascular pedicle. The recovery of muscle function of the ischemic/reperfused limb relative to that of the contralateral control limb was used as the index of recovery. By the end of the ischemic interval, no contractile activity was elicited with nerve stimulation for either the 1- or the 3-hr group. After 2 hr of reperfusion, the 1-hr group regained 0.558 .+-. 0.116 (mean .+-. SEM) of control function with nerve stimulation, while the 3-hr group regained only 0.016 .+-. 0.005 of control function (P < 0.01). In contrast, with direct muscle stimulation, the 1-hr group produced 0.580 .+-. 0.015 compared to 0.286 .+-. 0.042 (P < 0.001) after 3 hr of ischemia. After 2 hr of reperfusion, the 1-hr group recovered 0.805 .+-. 0.059 of muscle function which was significantly better than 0.580 .+-. 0.077 (P < 0.05) for the 3-hr ischemia group. Therefore, peripheral nerve is more susceptible to ischemia and short reperfusion intervals than skeletal muscle. Strategies for revascularization that may prove beneficial in the treatment of acute severely ischemic limbs may need to take into account the demonstrated injury of peripheral nerve function following relatively short periods of ischemia.