Résumé
PURPOSE: Vogt´s antioxidant solution (red blood cells, Ringer's solution, sodium bicarbonate, mannitol, allopurinol and 50% glucose) or its modification including hydroxyethyl starch (HES) were tested for the prevention of splanchnic artery occlusion shock. METHODS: Seventy rats were distributed in treatment (3), control (1), and sham (3) groups. Ischemia and reperfusion were induced by celiac, superior mesenteric and inferior mesenteric arteries occlusion for 40 min, followed by 60 min reperfusion or sham procedures. Controls received saline, both treatment and sham groups received the Vogt's solution, modified Vogt's solution (replacing Ringer's solution by HES), or HES. Mean arterial blood pressure (MABP), ileal malondialdehyde (MDA) and plasmatic MDA were determined, and a histologic grading system was used. RESULTS: At reperfusion, MABP dropped in all I/R groups. Only HES treatment was able to restore final MABP to the levels of sham groups. Plasmatic MDA did not show differences between groups. Ileum MDA was significantly higher in the control and treatment groups as compared to the sham group. Histology ranking was higher in the only in control group. CONCLUSIONS: Hydroxyethyl starch was able to prevent hemodynamic shock but not intestinal lesions. Both treatments with Vogt's solutions did not show any improvement. .
Sujets)
Animaux , Mâle , Hydroxyéthylamidons/pharmacologie , Artères mésentériques/effets des médicaments et des substances chimiques , Occlusion vasculaire mésentérique/prévention et contrôle , Substituts du plasma/pharmacologie , Lésion d'ischémie-reperfusion/prévention et contrôle , Modèles animaux de maladie humaine , Hémodynamique/effets des médicaments et des substances chimiques , Hydroxyéthylamidons/usage thérapeutique , Iléum/vascularisation , Iléum/anatomopathologie , Ischémie/prévention et contrôle , Solution isotonique/pharmacologie , Solution isotonique/usage thérapeutique , Malonaldéhyde/analyse , Artères mésentériques/anatomopathologie , Occlusion vasculaire mésentérique/anatomopathologie , Substituts du plasma/usage thérapeutique , Rat Wistar , Reproductibilité des résultats , Circulation splanchnique/effets des médicaments et des substances chimiques , Facteurs temps , Résultat thérapeutiqueRésumé
PURPOSE: To evaluate the effect of the ischemic preconditioning and the ischemic postconditioning over the tissue injury in the intestinal mucosa of rats undergoing the procedure of mesenteric ischemia and reperfusion. METHODS: Thirty Wistar rats were studied, divided in three groups: group A, undergoing mesenteric ischemia (30 minutes) and reperfusion (60 minutes); group B, mesenteric ischemia and reperfusion preceded by ischemic preconditioning; group C, mesenteric ischemia and reperfusion and, before the beginning of reperfusion, the ischemic postconditioning was performed. At the end, a segment of the small intestine was dissected for histological analysis. The results were evaluated using the CHIU et al.6 classification followed by the statistic treatment. RESULTS: The mean values of the tissue injury levels were: group A, 3.5; group B, 1.2; and group C, 1. The difference between the result of group A with the results of groups B and C was considered statistically significant (p < 0,05). CONCLUSION: The ischemic preconditioning and postconditioning are able to minimize the tissue injury in the intestines of rats that underwent the procedure of mesenteric ischemia and reperfusion.
OBJETIVO: Avaliar o efeito do pré e pós-condicionamento isquêmico sobre a lesão tecidual na mucosa intestinal de ratos submetidos ao processo de isquemia e reperfusão mesentérica. MÉTODOS: Foram estudados 30 ratos Wistar, distribuídos em três grupos: grupo A, em que se realizou isquemia (30 minutos) e reperfusão (60 minutos) mesentérica; grupo B, isquemia e reperfusão mesentérica precedidos pelo pré-condicionamento isquêmico; grupo C, isquemia e reperfusão mesentérica e, precedendo o início da reperfusão, foi realizado o pós-condicionamento isquêmico. Ao final, ressecou-se um segmento do intestino delgado para análise histológica. Avaliaram-se os resultados pela classificação de CHIU e col.6 e procedeu-se o tratamento estatístico. RESULTADOS: As médias dos graus de lesão tecidual foram: grupo A, 3,5; grupo B, 1,2; grupo C, 1. A diferença entre o resultado do grupo A com os resultados dos grupos B e C foi considerada estatisticamente significativa (p < 0,05). CONCLUSÃO: O pré e pós-condicionamento isquêmico foram capazes de minimizar a lesão tecidual na mucosa intestinal de ratos submetidos ao processo de isquemia e reperfusão mesentérica.
Sujets)
Animaux , Mâle , Rats , Muqueuse intestinale/vascularisation , Intestin grêle/vascularisation , Préconditionnement ischémique/méthodes , Occlusion vasculaire mésentérique/prévention et contrôle , Lésion d'ischémie-reperfusion/prévention et contrôle , Modèles animaux de maladie humaine , Muqueuse intestinale/anatomopathologie , Intestin grêle/anatomopathologie , Artère mésentérique supérieure , Occlusion vasculaire mésentérique/anatomopathologie , Rat Wistar , Lésion d'ischémie-reperfusion/anatomopathologie , Statistique non paramétriqueRésumé
Se discuten 13 casos de trombosis mesenterica aguda en igual numero de pacientes atendidos en el Hospital Universitario del Valle, Cali, en el periodo entre enero 1 de 1984 y diciembre 31 de 1985. Se revisan los casos segun sus manifestaciones clinicas, edad, sexo, extension del infarto y sus diferentes causas, y factores de riesgo asociados, asi como el tratamiento establecido. Se hace enfasis en el empleo precoz de la angiografia mesenterica como metodo diagnostico y via terapeutica para administrar vasodilatadores tipo papaverina como terapia unica o combinada con cirugia. Igualmente se describen las pautas utilizadas hoy en dia, para un descubrimiento mas temprano y adecuado de esta entidad, con el fin de rebajar las tasas de mortalidad