UW液联合丹参酮ⅡA动脉灌洗对缺血骨骼肌的保护作用  

The washout with UW solution and tanshinone ⅡA to lessen skeletal muscle ischemia-reperfusion injury

作　　者：王洪刚[1] 刘小林[1] 李智勇[2] 

机构地区：[1]中山大学附属第一医院显微创伤骨科,广州510080 [2]中山大学附属第三医院关节创伤骨科

出　　处：《中华显微外科杂志》2013年第5期464-468,共5页Chinese Journal of Microsurgery

基　　金：国家自然科学基金（81272021）;广东省医学科学基金（A2011164）

摘　　要：目的评估uw液联合不同剂量丹参酮ⅡA动脉灌洗对缺血骨骼肌的保护作用。方法建立大鼠后肢骨骼肌缺血模型，灌洗组于恢复血供前应用uw液和uw液联合丹参酮ⅡA（0．05、0．10、0．20mg／ml）进行动脉灌洗30min，然后恢复其血供，设为uw加T0．05；组、uw加T0．1组和uw加T0.2组；对照组不进行动脉灌洗直接恢复血供，每组8只。测定血清CPK、AST、LDH含量及骨骼肌中MDA、SOD、ATP酶活性以及骨骼肌水含量，并检测骨骼肌中血管内皮ICAM．1的表达，评估骨骼肌的再灌注损伤程度。结果恢复灌注2h，UW组中血清酶含量较对照组降低20％～30％（P〈0．05），而灌注4h和6h，两组间则差异无统计学意义（P〉0．05）。实验期间，uw加T0.05组、uw加R，组和uW加R：组中血清酶含量均显著低于对照组。缺血4h，4个动脉灌洗组中骨骼肌水含量、MDA、SOD和Na＋．K＋ -ATPase与对照组比较差异显著，但恢复灌注6h，仅uw加T0.05组、uw加T0.1组和uw加T0.2组与对照组比较差异有统计学意义（P〈0．05）。动脉灌洗组骨骼肌中血管内皮ICAM-1的表达受到不同程度的抑制，阳性血管比率与对照组比较显著降低。结论应用uw液和uw液联合丹参酮ⅡA动脉灌洗均可不同程度减轻缺血骨骼肌再灌注损伤，添加适量丹参酮UA（0．1～0．2mg／ml）可有效改善uw液对缺血骨骼肌的保护作用。Objective To assess the effect of intraarterial washout with UW solution and tanshinone ⅡA for skeletal muscle preservation during isehemia and reperfusion. Methods Ischemic rat limbs were perfused with UW solution or UW solution plus tanshinone ⅡA （ 0. 05, 0. 1 and 0. 2 mg/ml ） for 0. 5 h before reperfusion ; controls received no perfusion. Serum CPK, LDH, and AST were measured pre-ischemia and after reperfusion（ 2 h, 4 h, and 6 h）. Muscle water content, MDA, SOD, ATPase were assessed pre-reperfusion and after 6 h reperfusion. ICAM-1 was detected after 6 h reperfusion. Results Intraarterial washout with UW and UW ＋ T could inhibit the express of ICAM-1 in skeletal muscle. The serum levels of CPK, AST, and LDH in UW group were significant lower than those in control group after 2 h of reperfusion, but no difference was observed between UW group and control group after 4 h and 6 h of reperfusion. After 4 h of isehemia, there were significant differences in water content, MDA, SOD, and ATPase in skeletal muscle between UW group and control group, but no difference was found after 6 h of reperfusion. In contrast, all parameters of laboratory test and biochemical analyzing in UW ＋ T（0. 05, 0. 10, and 0. 20 mg/ml） groups were significantly different from those in control group at corresponding reperfusion period. Conclusion Intraarterial washout with UW solution is effective in preserving skeletal muscle integrity against I/R insult. Tanshinone ⅡA as a beneficial adjunct to UW solution improves the protective effect of UW solution for ischemic skeletal muscle. To better preserve ischemic skeletal muscle, an appropriate dose of tanshinone H A （0. 1 or 0. 2 mg/ml）added to UW solution is required.

关 键 词：动脉灌洗 UW液 丹参酮ⅡA 骨骼肌 

分 类 号：R285.5[医药卫生—中药学]