Effect of corvitin on oxygen homeostasis and blood gas transmitters in ischemia-reperfusion of the lower limbs
https://doi.org/10.24884/1682-6655-2021-20-2-37-44
Abstract
Introduction. Reperfusion-reoxygenation syndrome (RRS) after revascularization of the lower limbs in obliterating atherosclerosis of the arteries is accompanied by a violation of the oxygen transport function of the blood (OTFB) and the content of gas transmitters (GTs). Reperfusion injury affects not only the tissues of the lower limbs, but also of anatomically distant organs, which supposes that effective RRS correction is required. Aim. To study the effect of Corvitin on the OTFB parameters and the content of GT of nitrogen monoxide (NO) and hydrogen sulfide (H2S) in the venous blood of the forearm after revascularization of the lower limb in chronic atherosclerotic occlusion of the superficial femoral artery (SFA).
Materials and methods. The study included 118 male patients. Revascularization of the lower limb was carried out by the method of loop endaterectomy from the SFA. Patients of group I (n=52) received traditional medication, 51 patients of group II additionally received Corvitin. In the blood from the vein of the elbow bend before the operation, on the 3rd and 8th days after it, the indices of OTFB and GTs were determined.
Results. In group I, on the 3rd day after surgery, pO2 increased in relation to healthy individuals by 5.2–18.5%, while pCO2 decreased by 4.8–6.7%, depending on the stage of initial ischemia. The concentrations of NO and H2S increased by 9.2–50.1% and 9.2–21.1%, respectively. The increase in the parameters of hyperoxemia, hypocapnemia and GT after the return of blood circulation decreases with the use of Corvitin (p˂0.05). By the end of the early postoperative period, the indicators of OTFB and GT not only return to their initial values, but also do not significantly differ from the group of healthy individuals (p˃0.05).
Conclusion. The use of Corvitin effectively corrects violations of OTFB and GT during ischemia-reperfusion of the lower limbs, which prevents tissue reperfusion damage.
About the Authors
V. N. Zasimovich
Brest Regional Clinical Hospital
Belarus
Belarus
Zasimovich Vladimir N. – Head of the Department of Vascular Surgery
7, Medicinskaya str., Brest, 224027
V. V. Zinchuk
Grodno State Medical University
Belarus
Belarus
Zinchuk Victor V. – Doctor of Medical Sciences, Professor, Head of the Department of Normal Physiology
80, Gor’kogo str., Grodno, 230009
N. N. Ioskevich
Grodno State Medical University
Belarus
Belarus
Ioskevich Nikolai N. – Doctor of Medical Sciences, Professor of the 1st Department of Surgical Diseases
80, Gor’kogo str., Grodno, 230009
References
1. Калинин Р. Е., Пшенников А. С., Сучков И. А. Реперфузионное повреждение тканей в хирургии артерий нижних конечностей // Новости хир. – 2015. – Т. 23, № 3. – С. 348–352. [Kalinin RE, Pshennikov AS, Suchkov IA. Reperfusion injury of tissues in surgery of lower limb arteries. Novosti khirurgii. 2015;23(3):348–352. (In Russ.)]. Doi: 10. 18484/2305-0047.2015.3.348.
2. Hirschberg K. Combined superoxide dismutase mimetic and peroxynitrite scavenger protects against neointima formation after endarterectomy in association with decreased proliferation and nitro-oxidative stress. Eur. J. Vasc. Endovasc. Surg. 2010;40(2):168–175. Doi: 10.1016/j.ejvs.2010.03.024.
3. Santema TB. Not all patients with critical limb ischemia require revascularization. Eur. J. Vasc. Endovasc. Surg. 2017; 53(3):371–379.
4. Механизмы реперфузионного повреждения ишемизированных тканей и возможности фармакологической коррекции метаболических расстройств при гипоксических состояниях / Н. П. Чеснокова, Г. Е. Брилль, В. В. Моррисон, М. Н. Бизенкова // Науч. обозрение: Мед. науки. – 2017. – № 2. – С. 64–66. [Chesnokova NP, Brill GE, MorrisonVV, Bizenkova MN. Mechanisms of reperfusion damage to ischemic tissues and the possibility of pharmacological correction of metabolic disorders in hypoxic conditions. Scientific Review. Medical sciences. 2017;(2):64–66. (In Russ.)].
5. 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS). Eur. Heart. 2017;39(9):763– 816. Doi: 10.15829/1560-4071-2018-8-164-221.
6. Небылицин Ю. С., Кутько Е. А. Синдром ишемииреперфузии нижних конечностей // Вестн. ВГМУ. – 2018. – Т. 17, № 6. – С. 18–31. [Nebylicin JuS, Kutko EA. Lower limb ischemia-reperfusion syndrome. Vestnik VSMU. 2018;17(6):18–31. (In Russ.)]. Doi: 10.22263/2312-4156.2018.6.18.
7. Калинин Р. Е., Сучков И. А., Пшенников А. С. Эндотелиальная дисфункция и способы ее коррекции при облитерирующем атеросклерозе. – М.: ГЭOТАР-Медиа, 2014. – C. 152. [Kalinin RE, Suchkov IA, Pshennikov AS. Endothelial dysfunction and methods of its correction in atherosclerosis obliterans. M.: GEOTAR-Media, 2014:152. (In Russ.)]. Doi: 10.23888/hmj201972283-293.
8. Засимович В. Н., Иоскевич Н. Н. Реперфузионнореоксигенационный синдром как проблема реконструктивной хирургии артерий при хронической ишемии нижних конечностей атеросклеротического генеза // Новости хир. – 2017. – Т. 25, № 6. – С. 632–642. [Zasimovich VN, Ioskevich NN. Reperfusion (Reoxygenation) Injury as a Problem of the Artery Reconstructive Surgery of in Atherosclerotic Genesis Chronic Ischemia of the Lower Limbs. Novosti khirurgii. 2017;25(6):632–642. (In Russ.)]. Doi: 10.18484/2305-0047.2017.6.632.
9. Прооксидантно-антиоксидантное состояние крови при хронической атеросклеротической окклюзии поверхностной бедренной артерии и после петлевой эндатерэктомии / В. Н. Засимович, В. В. Зинчук, Н. Н. Иоскевич, И. Э. Гуляй // Новости мед.-биол. наук. – 2020. – Т. 20, № 3. – С. 108–115. [Zasimovich VN, Zinchuk VV, Ioskevich NN, Gulyai IE. Prooxidant-antioxidant balance of the blood during chronic atherosclerotic occlusion of the superficial femoral artery and after loop endarterectomy. News of and Biomedical Sciences. 2020;20(3):108–115. (In Russ.)]. Doi: 10.25298/2221-8785-2020-18-5-556-563.
10. Мойбенко А. А. Биофлавоноиды как органопротекторы (кверцитин, корвитин, квертин). – Киев: Навукова думка, 2012.– C. 275. [Moybenko AA, red. Bioflavonoids as organoprotectors (quercetin, corvitin, quertin). Kiev: Navukova Dumka. 2012:275. (In Russ.)].
11. Мищенко Т. С., Дмитриева Е. В. Комбинированная терапия препаратами Корвитин и Аксотилин в лечении больных с ишемическим инсультом // Международ. невролог. жур. – 2018.– № 1.– С. 31–36. [Mishchenko TS, Dmitrieva EV. Combined therapy with drugs Corvitin and Axotilin in the treatment of patients with ischemic stroke. International neurological journal. 2018;(1):31–36. (In Russ.)]. Doi: 10.22141/2224-0713.1.95.2018.127410.
12. Тронько Н. Д., Кузнецова С. М., Черская М. С. Биофлованоиды в лечении пациентов с сахарным диабетом 2-го типа и церебральным атеросклерозом // Эндокринология. – 2020. – Т. 2, № 1.– С. 33–41. [Tronko ND, Kuznetsova SM, Cherskaya MS. Bioflovanoids in the treatment of patients with type 2 diabetes mellitus and cerebral atherosclerosis. Endocrinology. 2020;2(1):33–41. (In Russ.)]. Doi: 10.31793/1680-1466.2020.25-1.33.
13. Гапонова Т. И., Кобеляцкий Ю. Ю., Панченко Г. В. Роль корвитина и латрена в профилактике и терапии реперфузионного синдрома при реконструктивных операциях у пациентов с хронической ишемией нижних конечностей // Медицина неотлож. сост.– 2015.– Т. 65.– С. 120–124. [Gaponova TI, Kobelyatsky YuYu, Panchenko GV. The role of corvitin and latrene in the prevention and treatment of reperfusion syndrome during reconstructive operations in patients with chronic ischemia of the lower limbs. Medicine of emergency conditions. 2015;65(2):120–124. (In Russ.)].
14. Sеveringhaus JW. Blood gas calculator. Journal of Applied Physiology. 1966;21(5):1108–1116.
15. Bryan NS, Grisham МВ. Methods to detect nitric oxide and its metabolites in biological samples. Free Radic. Biol. Med. 2007;43(5):645–657. Doi: 10.1016/j.freeradbiomed.2007.04.026.
16. Norris EJ. The liver as central regulator of hydrogen sulfide. Shock. 2011;36(3):242–250.
17. Gladwin MT. Nitric oxide for inhalation in the acute treatment of sickle cell pain crisis: a randomized controlled trial. JAMA. 2011;305(9):893-902. Doi: 10.1001/jama.2011.235.
18. Покровский А. В., Казаков Ю. И., Лукин И. Б. Критическая ишемия нижних конечностей. Инфраингвинальное поражение. Тверь: Твер. гос. ун-т, 2018. – C. 225. [Pokrovsky AV, Kazakov YuI, Lukin IB. Critical ischemia of the lower limbs. Infrainguinal lesion. Tver: Tver. state un-t. 2018:225. (In Russ.)].
19. Колесников С. И., Власов Б. Я., Колесникова Л. И. Сероводород как третья эссенциальная газовая молекула живых тканей // Вестн. РАМН. – 2015. – Т. 70, № 2. – С. 237–241. [Kolesnikov SI, Vlasov BYa, Kolesnikova LI. Hydrogen sulfide as the third essential gas molecule of living tissues. Bulletin of the RAMS. 2015;70(2):237–241. (In Russ.)].
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For citations:
Zasimovich V.N., Zinchuk V.V., Ioskevich N.N. Effect of corvitin on oxygen homeostasis and blood gas transmitters in ischemia-reperfusion of the lower limbs. Regional blood circulation and microcirculation. 2021;20(2):37-44. (In Russ.) https://doi.org/10.24884/1682-6655-2021-20-2-37-44
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