摘要：
目的 观察不同的保存断肢方法对再植后肌肉生物学特性的影响.方法 用ETK液(extracellular-type trehalose containing kyoto solution),UW液(university of wisconsin solution),LR液(lactated ringer's solution).在4°C保存大鼠断肢6 h或24 h,并进行原位移植.移植8周后,检测胫骨前肌的末端潜伏期和振幅,以及血清中肌酸磷酸激酶、钾、天门冬氨酸转氨酶等含量水平,并用苏木素-伊红染色和马氏三色染色检查肌肉组织学形态.结果 ETK-6 h、UW-6 h和LR-6 h三个实验组末端潜伏期相似,但LR组的电振幅低于其他两组.从组织形态上看,LR液中保存的肌肉萎缩程度最高.在24 h保存后移植模型中,LR组的存活率是37.5％,而在ETK和UW组中则为80％.LR组由于严重的肌肉萎缩和纤维化导致没有检测肌电流,而ETK组和UW组电生理学结果显示出肌肉的良好功能.结论 ETK保存液可以保护局部缺血再灌注损伤的肢体肌肉的形态和功能,并且增加长期保存后的肢体移植存活率,且 ETK液更优于 UW液.%Objective To observe the relationship of biologicalcharacteristics of amputated limb muscle between with different preservation methods.Methods Quadriceps femoris muscles from Wistar rats werepreserved for 24 hours at 4°C in extracellular-type trehalose containingKyoto (ETK),University of Wisconsin (UW),or lactated Ringer's (LR)solution (control).Amputated limbs of rats preserved with ETK,UW,or LR for6 or 24 hours at 4°C were transplanted orthotopically.Blood samples from the external jugular vein were obtained 60 minutes after surgery for a-nalysis of serumlevels of creatine phosphokinase (CPK),aspartate aminotransferase (AST),alanine aminotransferase (ALT),lactate dehydrogenase (LDH),creatinine (Cr),bloodurea nitrogen (BUN),and potassium (K).At week 8,ter-minallatency and amplitude were measured in the tibialis anterior muscle.Themuscles were also analyzed histologically by hematoxylin and eosin staining (HE)and Masson's trichrome staining.Results In the 6-hour-preserved limb trans-plantation model,electrical amplitude was significantly lower inthe LR group.Histologically,muscles preserved with LR showed the mostatrophic changes.In the 24-hour-preserved model,the survival rate of the LR group was 37.5％ in con-trast to 80％ in the ETK and UW groups.Electrical signals were not detected in the LR group owing to severe muscle atrophy and fibrosis.The ETK and UW groups showed good muscle functionelectrophysiologically.Conclusion ETK solutions can protect muscle function and morphology in ischemia-reperfusion limbs and improve recipient survivalrates after transplantation of long-term-preserved limbs.
