Direct hemoperfusion with a polymyxin B-immobilized cartridge in intestinal warm ischemia reperfusion

查看全文 作　　者：Hiroaki [1]Sato;Kazuhisa [1]Arakawa;Katsumi [1]Kobayashi;Hodaka [1]Yamazaki;Yujin [1]Suto;Izumi [1]Takeyoshi;Kiyohiro [2]Oshima

机构地区：[1]Department of Thoracic and Visceral Organ Surgery,Gunma University Graduate School of Medicine,Maebashi,Gunma 371-8511,Japan;[2]Intensive Care Unit,Gunma University Hospital,Maebashi,Gunma 371-8511,Japan

出　　处：《World Journal of Gastroenterology》索引2008年第14卷第35期,共6页

摘　　要：AIM: To investigate the effectiveness of direct hemo- perfusion with polymyxin B-immobilized fibers (DHP- PMX therapy) on warm ischemia-reperfusion (I/R) injury of the small intestine. METHODS: The proximal jejunum and distal ileum of mongrel dogs were resected. Warm ischemia was performed by clamping the superior mesenteric artery (SMA) and vein (SMV) for 2 h. Blood flow to the proximal small intestine was restored 1 h after reperfusion, and the distal small intestine was used as a stoma. The experiment was discontinued 6 h after reperfusion. The dogs were divided into two groups: the DHP-PMX group (n = 6, DHP-PMX was performed for 180 min; from 10 min prior to reperfusion to 170 min after reperfusion) and the control group (n = 5). The rate pressure product (RPP), SMA blood flow, mucosal tissue blood flow, and intramucosal pH (pHi) were compared between the two groups. The serum interleukin (IL)-10 levels measured 170 min after reperfusion were also compared. RESULTS: The RPP at 6 h after reperfusion was significantly higher in the PMX group than in the control group (12 174 ± 1832 mmHg/min vs 8929 ± 1797 mmHg/min, P < 0.05). The recovery rates ofthe SMA blood flow at 1 and 6 h after reperfusion were significantly better in the PMX group than in the control group (61% ± 7% vs 44% ± 4%, P < 0.05, and 59% ± 5% vs 35% ± 5%, P < 0.05, respectively). The recovery rate of the mucosal tissue blood flow and the pHi levels at 6 h after reperfusion were significantly higher in the PMX group (61% ± 8% vs 31% ± 3%, P < 0.05 and 7.91 ± 0.06 vs 7.69 ± 0.08, P < 0.05, respectively). In addition, the serum IL-10 levels just before DHP-PMX removal were significantly higher in the PMX group than in the control group (1 569 ± 253 pg/mL vs 211 ± 40 pg/mL, P < 0.05). CONCLUSION: DHP-PMX therapy reduced warm I/R injury of the small intestine. IL-10 may play a role in inhibiting I/R injury during DHP-PMX therapy. 关键词：肠疾病缺血/再灌注损伤多粘菌素消化系统疾病

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Direct hemoperfusion with a polymyxin B-immobilized cartridge in intestinal warm ischemia reperfusion

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