摘要
目的 研究负压封闭引流（vacuum sealing drainage，VSD）技术干预下局部氧分压（oxygen partial pressure，PtO2）的变化，并探讨VSD 减轻兔骨骼肌缺血- 再灌注损伤（ischemia reperfusion injury，I/R）的可能机制。方法 于同济医院急诊创伤外科实验室，将30 只新西兰兔随机（随机数字法）分成对照（假手术）组、I/R 组和I/R＋VSD 组，每组10 只。通过阻断左后肢股动静脉（4 h）和恢复再灌注（6 h）的方法建立兔I/R 模型，根据远端是否存在动脉搏动作为判断建模成功的标准。在此基础上使用VSD 技术进行再灌注时的干预，分别于建模前、再灌注前、再灌注后3 h 或实验结束后等数个时间点，在损伤肌肉区域测量、取样及耳缘静脉抽血，对各组PtO2、低氧诱导因子-1α（hypoxia inducible factor 1 alpha，HIF-1α）mRNA 和蛋白、以及乳酸（lactic acid，LA）的含量进行检测。所得数据采用方差分析、LSD-t 法或Tamhane＇s T2 法进行统计学分析。结果 （1）PtO2：建模后，I/R 组和I/R＋VSD 组PtO2 均下降，但两组间差异无统计学意义（t=1.322,P=0.296）；恢复再灌注后两组PtO2 显著上升，但仍低于对照组（F=8.334，P=0.006），且在此期间I/R＋VSD 组持续低于I/R 组直至实验结束（t=2.015，P=0.046）；（2）HIF-1α mRNA ：与对照组比较，I/R 组和I/R＋VSD 组HIF-1α mRNA 在建模后2 h 和4 h 时均显著升高（F=10.120，P=0.002和F=36.480，P〈0.01）；恢复再灌注后，I/R 组和I/R＋VSD 组虽较前降低，但仍高于对照组（F=6.960，P=0.015 和F=4.470，P=0.035）；且I/R＋VSD 组显著高于I/R 组（t=1.799，P=0.048 和t=5.911，P=0.019）；（3）HIF-1α 蛋白：与对照组比较，I/R 组HIF-1α 蛋白表达在再灌注前和再灌注后3 h显著升高（t=15.567，P〈0.01 和t=2.768，P=0.031）；I/R＋VSD 组HIF-1α 蛋白表达在再灌注前、再灌注后3 h 和6 h 均显著升高（t=13.438，P〈0.01 ；t=7.854�
Objective To measure the oxygen partial pressure （Pt02） within a situation of vacuum sealing drainage （VSD） implement, and to discuss the potential mechanism of VSD alleviating skeletal muscle ischemia reperfusion （I/R） injury in rabbits. Methods Rabbits were randomly（random number） divided into three groups： sham （n=10）, I/R （n=10） and I/R＋VSD （n=10） groups. In the I/R group, left hind limb ischemia was induced by clamping the femoral artery and vein for 4 h, then released for 6 h, to allow reperfusion of the limb. VSD was only performed in the I/R＋VSD group during the reperfusion period.All rabbits were administered a series test of PtO2 in different time points before and after reperfusion, and the left hind limb skeletal muscle and ear vein blood samples were immediately harvested for biochemical analyses, including hypoxia inducible factor 1 alpha （HIF-1 ct） mRNA and protein, and lactic acid （LA）. One-way analysis of variance （ANOVA）, Fisher＇s least significant difference （LSD） test or Tamhane＇s T2 test was used where appropriate to analyze the experimental results. Results The levels of PtO2 in the I/R and I/R＋VSD groups were decreased after ischemia, but no significant difference was noted between the two groups （t=1.322, P=0.296）. The PtO2 levels in the I/R＋VSD group were less increased than those in the UR group after reperfusion （t=2.015, P=0.046）. The levels of HIF-1 ct mRNA and protein were increased after UR injuries （F=10.120, P=0.002; F=36.480, P〈0.01; F=6.960, P=0.015, F=4.470, P=0.035）, and the levels in the I/R＋VSD group were greater than those in the I/R group （t=-1.799, P=0.048, t=5.911, P=0.019; t=-1.878, P=0.046, t=2.609, P=0.030）. The LA levels were significantly increased in the skeletal muscle and blood samples in the I/R and I/R＋NPWT groups compared with those in the sham group at the final stage （F=9.540, P=0.002 and F=13.750, P〈0.01）, but the levels in the I/R＋VSD group were less than those in the I
作者
王翔
杨帆
解杰
陈驾君
李占飞
白祥军
Wang Xiang, Yang Fan, Xie Jie, Chen Jiajun, Li Zhanfei, Bai Xiangjun(Department of Traumatic Surgery, Affiliated Tongji hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China)
出处
《中华急诊医学杂志》
CAS
CSCD
北大核心
2018年第11期1218-1223,共6页
Chinese Journal of Emergency Medicine
基金
湖北省科技厅自然科学基金面上项目（2018CFB743）
关键词
创伤
缺血-再灌注损伤
负压封闭引流
组织氧分压
低氧诱导因子-1Α
乳酸
Trauma
Ischemia reperfusion injury
Vacuum sealing drainage
Oxygen partial pressure
Hypoxia inducible factor 1 alpha
Lactic acid
