摘要
目的评价一氧化氮在七氟醚预处理减轻兔心肌缺血再灌注损伤中的作用。方法健康雄性新西兰大白兔40只，体重2．1～2．9kg，随机分为5组（n=8）：缺血再灌注组（IR组）、七氟醚预处理组（SEV组）、L-NAME组、七氟醚预处理＋L-NAME组（SL组）和L-NAME＋七氟醚预处理组（LS组）。采用结扎冠状动脉前降支45min，再灌注3h的方法制备兔心肌缺血再灌注模型。SEV组吸入1．7％七氟醚30min，洗脱15min行预处理后制备模型；L-NAME组静脉注射一氧化氮合酶（NOS）抑制剂L-NAME 1mg／kg，5min后制备模型；SL组七氟醚预处理后，静脉注射L-NAME 1mg／kg，5min后制备模型；LS组静脉注射L-NAME 1mg／kg，5min后行七氟醚预处理，制备模型。于模型制备前即刻（T0）、心肌缺血45min（T1）、再灌注60min（T2）、120min（T3）、180min（T4）时记录HR、MAP、左室收缩压（LVSP）和左室收缩压最大上升速率（＋dp／dtmax），于T4时抽取股动脉血3ml，测定血浆心肌肌钙蛋白T（cTnT）浓度、心肌磷酸肌酸激酶（CK-MB）和乳酸脱氢酶（LDH）活性，取心室肌组织，测定心肌缺血危险区（AAR）和梗塞区（IS）面积，并计算IS／AAR。结果与IR组比较，SEV组缺血再灌注时＋dp／dtmax升高，血浆cTnT浓度、CK-MB和LDH活性和心室肌IS／AAR降低（P〈0．05），其余组上述指标差异均无统计学意义（P〉0．05）。结论一氧化氮参与了七氟醚预处理减轻兔心肌缺血再灌注损伤，一氧化氮可能是其保护作用中某一通路上的信号分子。
Objective To evaluate the role of nitric oxide （NO） in sevoflurane preconditioning-induced amelioration of myocardial ischemia-reperfusion injury （I/R） in rabbits. Methods Forty healthy New Zealand white rabbits weighing 2.1-2.9 kg were randomly divided into 5 groups （n = 8 each）： group Ⅰ I/R; group Ⅱ sevoflurane preconditioning （SEV） ; group Ⅲ L-NAME; group Ⅳ SEV ＋ L-NAME and group Ⅴ L-NAME ＋ SEV. The animals were anesthetized with pentobarbital, tracheostomized, intubated and mechanically ventilated （VT = 15 ml/kg, RR = 35 bpm, FiO2 = 50% ）. PETCO2 was maintained at 30-35 mm Hg. MAP, HR, LVSP and ＋ dp/dt were monitored. Myocardial I/R was produced by occlusion of left anterior descending branch of coronary artery for 45 min followed by 3 h reperfusion. In group SEV（group Ⅱ ） 1.7% SEV was inhaled for 30 min followed by 15 rain washout before myocardial I/R. In group L-NAME （group Ⅲ ） L-NAME （the NOS inhibitor） 1 mg/kg was given iv 5 min before I/R. In group Ⅳ L-NAME 1 mg/kg was given iv between SEV preconditioning and I/R and in groupV L-NAME 1 mg/kg was given iv before SEV preconditioning and I/R. MAP, HR, LVSP and ＋ dp/dtmax, were recorded at 30 min stabilization （baseline）, at the end of 45 min myocardial ischemia （T1 ）, and at 60, 120 and 180 min of reperfusion （T2-4 ）. Blood samples were taken at T4 for determination of plasma concentration of cTnT, activation of CK-MB and LDH. The hearts were then removed for determination of infarct size （IS） and the area at risk of ischemia （AAR）. IS/AAR was calculated. Results ＋ dp/dtmax was significantly higher, the plasma concentration of cTnT and activity of CK-MB and LDH and IS/AAR were significandy lower at T4 in group SEV （ group Ⅱ ） than in group I/R （ group Ⅰ ） （ P 〈 0.05 ）. There were no significant differences in the hemodynamics, plasma cTnT concentration, CK-MB and LDH activities and IS/AAR between group Ⅰ （I/R） and group Ⅲ , Ⅳ and Ⅴ （ P 〉 0.05
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2008年第9期828-831,共4页
Chinese Journal of Anesthesiology
关键词
一氧化氮
心肌再灌注损伤
缺血预处理
七氟醚
Nitric oxide
Myocardial reperfusion injury
Ischemic preconditioning
Sevoflurane
