The experimental study for avoidance and prediction of Myonephropathic-metabollic syndrome (MNMS)

骨骼肌再灌注损伤后的肌肾病-代谢综合征（MNMS）是急性动脉闭塞性疾病的严重和致命的并发症。为了避免和预测MNMS，在再灌注前即刻评估骨骼肌的缺血性损伤是必要的。本实验采用骨骼肌电特性测定方法，对犬下肢缺血性损伤和再灌注损伤进行了实验和临床研究。1.麻醉犬11只，双侧后肢腹股沟区挤压造成缺血，经不同时间段（0.05 ± 0.05）进行再灌注。（I组，N=3）、1h（II组，N=3）、3 h（III组，N=4）、6 h（IV组，N=1）。用LCR仪测量后肢骨骼肌的电导率（G）。测定再灌注3 h后肢G的变化（Δ 3G）。从缺血前至再灌注10 h间断测定血清CPK和Ald. ...更多信息 在AAA（N=3）、阿索（N=1）或急性动脉闭塞（n=1）患者中，从动脉夹闭到解除夹闭测量下肢G。在实验研究中，G在缺血时降低，再灌注后升高。I、II组CPK、Ald无明显变化，III、IV组CPK、Ald明显升高。DELTA 3G在2.1mS/cm以下时，再灌注后CPK、Ald无明显升高。而DELTA 3G> 2.1mS/cm的犬再灌注后则明显增加。再灌注后10小时CPK与Ald相关性良好在临床研究中，仅AAO患者下肢G明显增高，且CPK明显高于其他患者，提示G的测定可用于监测骨骼肌缺血性损伤及再灌注时相。适用于骨骼肌再灌注损伤的预测。少

Myonephropathic-metabolic syndrome (MNMS) following after reperfusion injury in the skeletal muscle is critical and lethal complication in acute arterial occlusive disease. For avoidance and prediction of MNMS,instantaneous assesment of ischemic damage of the skeletal muscle before reperfusion is essential. We performed experimental and clinical studies with measurement of electrical character in the skeletal muscle to assess ischemic damage and reperfusion injury in lower limbs.1.In eleven anesthetized dogs, the bilateral hindlimbs were squeezed at the inguinal region to make ischemia and they were reperfused after various intervals, which were Oh(Group I,N=3), 1h(Group II,N=3), 3h(Group III,N=4), 6h(Group IV,N=1). Electrical conductivity(G) of the skeletal muscles in hindlimbs was measured with an LCR meter. Change of G in hindlims during 3 hours of reperfusion(DELTA3G) were measured. Serum CPK and aldlase (Ald) were measured intermittently from preischemia to 10 hours reperfusion.2. … More In patients with AAA (N=3), ASO(N=1), or acute arterial occlusion(n=1), G of lower extremities was measured from arterial clamp to declamp. Serum CPK was measured during surgical operation and postoperative period, intermittently.In Experimental study, G was decreased during ischemia, and increased after reperfusion. In group I and II,CPK and Ald showed no significant changes, but in group III and IV,they increased significantly. In dogs indicated under 2.1mS/cm of DELTA3G,CPK and Ald were not increased after reperfusion. but in dogs indicated with more than 2.1mS/cm of DELTA3G they increased significantly after reperfusion. CPK and Ald at 10 hours after reperfusion correlated well (P<0.001) to DELTA3G in dogs whose DELTA3G were more than 2.1mS/cm.In clinical study, only AAO patient showed significant increase of G in lower extremities and he showed higher CPK than the other patients.We suggested that measurement of G may provide monitoring of ischemic injury of the skeletal muscle and reperfused phase, and be applicable to prediction of the skeletal muscular reperfusion injury. Less