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首页> 外文期刊>Translational Stroke Research >Muscle Microdialysis to Confirm Sublethal Ischemia in the Induction of Remote Ischemic Preconditioning
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Muscle Microdialysis to Confirm Sublethal Ischemia in the Induction of Remote Ischemic Preconditioning

机译：肌肉微透析可证实亚致死性缺血在诱导远程缺血预处理中的作用

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摘要

Exposure of one tissue to ischemia–reperfusion confers a systemic protective effect, referred to as remote ischemic preconditioning (RIPC). Confirmation that the desired effect of ischemia is occurring in tissues used to induce RIPC requires an objective demonstration before this technique can be used consistently in the clinical practice. Enrolled patients underwent three to four RIPC sessions on non-consecutive days. Sessions consisted of 4 cycles of 5 min of leg cuff inflation to 30 mmHg above the systolic blood pressure followed by reperfusion. Absence of leg pulse was confirmed by Doppler evaluation. To evaluate limb transient ischemia, patients were monitored with muscle microdialysis. Glucose, lactate, lactate/pyruvate ratio, and glycerol levels were measured. Fourteen microdialysis sessions were performed in seven patients undergoing RIPC (42.8 % male; mean age, 51.8; Fisher grade 4 in all seven patients, Hunt and Hess grade 5 in five patients, four in one patient and one in one patient). An average follow-up of 29 days demonstrated no complications associated with the procedure. Muscle microdialysis during RIPC sessions showed a significant increase in lactate/pyruvate ratio (21.2 to 26.8, p = 0.001) and lactate (3.0 to 3.9 mmol/L, p = 0.002), indicating muscle ischemia. There was no significant variation in glycerol (234 to 204 μg/L, p = 0.43), indicating no permanent cell damage. The RIPC protocol used in this study is safe, well tolerated, and induces transient metabolic changes consistent with sublethal ischemia. Muscle microdialysis can be used safely as a confirmatory tool in the induction of RIPC.
机译：将一个组织暴露于局部缺血-再灌注会产生全身保护作用，这称为远程缺血预处理（RIPC）。在将这种技术用于临床实践之前，需要客观证明要证实缺血的理想作用发生在用于诱导RIPC的组织中。入选患者在非连续日接受三至四次RIPC疗程。会议包括4个周期，每5分钟将腿袖带充气至收缩压以上30 mmHg，然后再灌注。多普勒评估证实无腿搏动。为了评估肢体短暂性缺血，对患者进行了肌肉微透析监测。测量葡萄糖，乳酸盐，乳酸盐/丙酮酸盐的比率和甘油水平。在接受RIPC的7例患者中进行了14次微透析治疗（男性为42.8％；平均年龄为51.8；在所有7例患者中为Fisher级4级；在5例患者中为Hunt和Hess 5级；在5例中为4例，在1例中为1例）。平均随访29天，未发现与手术相关的并发症。 RIPC期间的肌肉微透析显示乳酸/丙酮酸比（21.2至26.8，p = 0.001）和乳酸（3.0至3.9 mmol / L，p = 0.002）显着增加，表明肌肉缺血。甘油无明显变化（234至204μg/ L，p = 0.43），表明没有永久性细胞损伤。这项研究中使用的RIPC协议是安全的，耐受性良好，并诱导与致死性局部缺血一致的短暂代谢变化。肌肉微透析可以安全地用作诱导RIPC的确认工具。

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  • 来源
    《Translational Stroke Research》 |2012年第2期|266-272|共7页
  • 作者

    Arzu Bilgin-Freiert; Joshua R. Dusick; Nathan R. Stein; Maria Etchepare; Paul Vespa; Nestor R. Gonzalez;

  • 作者单位

    Departments of Neurosurgery and Radiology UCLA David Geffen School of Medicine 10833 LeConte Ave. Room 18-251 Semel Los Angeles CA 90095-7039 USA;

    Departments of Neurosurgery and Radiology UCLA David Geffen School of Medicine 10833 LeConte Ave. Room 18-251 Semel Los Angeles CA 90095-7039 USA;

    Departments of Neurosurgery and Radiology UCLA David Geffen School of Medicine 10833 LeConte Ave. Room 18-251 Semel Los Angeles CA 90095-7039 USA;

    Departments of Neurosurgery and Radiology UCLA David Geffen School of Medicine 10833 LeConte Ave. Room 18-251 Semel Los Angeles CA 90095-7039 USA;

    Departments of Neurosurgery and Radiology UCLA David Geffen School of Medicine 10833 LeConte Ave. Room 18-251 Semel Los Angeles CA 90095-7039 USA;

    Departments of Neurosurgery and Radiology UCLA David Geffen School of Medicine 10833 LeConte Ave. Room 18-251 Semel Los Angeles CA 90095-7039 USA;

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  • 正文语种 eng
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  • 关键词

    Metabolic changes; Muscle microdialysis; Remote ischemic preconditioning; Ischemia;

    机译：代谢变化;肌肉微透析;远程缺血预处理;局部缺血;

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