肢体创伤对机体释放内皮素1及断肢血流量的影响  

Surgical injuries influence on release of endothelin1 and local blood perfusion of amputated extremities

作　　者：王涛[1,2] 顾玉东[1,2] 谭文秀[1,2] 金惠铭 

机构地区：[1]上海医科大学华山医院手外科 [2]上海医科大学病理生理教研组

出　　处：《中华外科杂志》1998年第9期561-563,共3页Chinese Journal of Surgery

基　　金：国家自然科学基金

摘　　要：目的观察肢体创伤对内皮细胞合成与释放内皮素１（ＥＴ１）及断肢血流量的影响，探讨肢体创伤后血管痉挛的原因。方法采用放射免疫检测法及激光多普勒血流仪，对１８例患者手术前后的血浆及８０只断肢大鼠股动脉壁ＥＴ１含量进行检测，同时对断肢残端血流量进行观察。结果手术创伤患者术后血浆ＥＴ１浓度明显升高，术后４小时达峰值，约为对照组的３倍；断肢大鼠股动脉壁ＥＴ１含量也明显增高，断肢后２小时达高峰，比对照组增高５３９％，以后逐渐下降；断肢残端的血流量也相应降低，断肢后２小时最低，仅为对照组的２５％，股动脉壁ＥＴ１含量与断肢血流量呈负相关（ｒ＝－０８３）。结论肢体创伤刺激内皮细胞合成和释放ＥＴ１，可能是创伤后血管痉挛的重要原因之一。Objective To observe influence of amputations and surgical injuries on synthesis and release of endotheliumderived endothelin1,and local blood perfusion of amputated extremities. Method The plasma endothelin1 concentrations of 18 patients preoperatively and postoperatively and the endothelin1 concentrations of femoral artery wall in 80 SD rats were determined using radioimmunoassay technique before and after amputation. Local blood perfusion of amputated extremities in rats were determined using laser Doppler flowmetry. Result The plasma endothelin1 concentrations in the patients with surgical injuries increased obviously, reached peak value at fourth hour postoperatively, being approximately 3 times of that of the control group. The endothelin1 concentrations of femoral artery wall in amputated rats also increased, reached peak value at second hour after amputation, being approximately 2 times of that of the control group, and then decreased gradually, at the same time the local blood perfusion decreased, reached its lowest value at second hour after amputation, being only 25 percent of the control value. The endothelin1 concentration of rat femoral artery wall was negatively relative to local blood perfusion(r=-083). Conclusion Injuries enhance synthesis and release of endothelin1.It is probably one of the main causes of vasospasm after injuries.

关 键 词：断肢 肢体创伤 四肢 创伤 内皮素-1 血流量 

分 类 号：R658.02[医药卫生—外科学]