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目的 :探讨缺血再灌注 (I/R)期间肌皮瓣静脉血浆一氧化氮 (NO)、肿瘤坏死因子 -α(TNF -α)、白细胞介素 - 1β(IL - 1β)变化规律及其在肌皮瓣I/R损伤发生中的作用。 方法 :湖北雄性白种猪 8头 ,其中实验组及对照组各 4头。制备双侧岛状腹直肌肌皮瓣 ,实验组缺血 8h ,再灌注 4h。采用Griess重氮化反应法及放射免疫分析法检测I/R不同时点肌皮瓣静脉血浆NO、TNF -α及IL - 1β的含量。采用依赖H2 O2 反应产物比色法检测再灌注毕组织髓过氧化酶 (MPO)活性 ,并观察组织病理改变。结果 :再灌注 0 .5 ,1,2h ,实验组NO含量低于对照组 (P <0 .0 1,P <0 .0 5 ,P <0 .0 5 ) ;再灌注 1,2 ,4h ,实验组TNF -α含量高于对照组 (P均 <0 .0 1) ;再灌注 2 ,4h ,实验组IL - 1β含量高于对照组 (P均 <0 .0 1) ;再灌注毕 ,实验组MPO含量高于对照组 (P <0 .0 1)。 结论 :肌皮瓣I/R期间存在局部细胞因子网络失衡 ;内皮源性NO生成减少、促炎性细胞因子TNF -α、IL - 1β释放参与了中性粒细胞介导的I/R损伤。
Objective: To investigate the changes of nitric oxide (NO), tumor necrosis factor - α (TNF - α) and interleukin - 1β (IL - 1β) in the myocutaneous flap during ischemia / reperfusion (I / R) The role of myocutaneous flap in I / R injury. Methods: Eight male white pigs in Hubei Province, including 4 experimental and control groups. Preparation of bilateral rectus abdominis myocutaneous flap, experimental group ischemia 8h, reperfusion 4h. Griess diazotization and radioimmunoassay were used to detect the contents of NO, TNF-α and IL - 1β in venous blood of myocutaneous flap at different time point of I / R. H 2 O 2 reactivity colorimetric assay was used to detect the activity of MPO and the histopathological changes were observed. Results: At 0.5 and 1, 2 h of reperfusion, NO content in the experimental group was lower than that in the control group (P <0.01, P <0.05, P <0.05) (P <0.01). The levels of IL - 1β in the experimental group were significantly higher than those in the control group (P <0.01) after reperfusion for 2 and 4 hours. The levels of TNF - α in the experimental group were significantly higher than those in the control group , The experimental group MPO content higher than the control group (P <0. CONCLUSION: Local imbalance of cytokines is present during I / R of myocutaneous flap, NO production is reduced, and release of pro-inflammatory cytokines TNF-α and IL-1β is involved in neutrophil-mediated I / R injury.