摘要
目的研究心肺复苏后大鼠肝细胞损伤的机制及丙泊酚（propofol）预处理的保护作用。方法采用窒息（琥珀酰胆碱）合并0．5mol／L冰氯化钾停跳液致大鼠心脏骤停，停跳5min后开始心肺复苏。健康Sprague Dawley雄性大鼠56只，随机分7组：Con组（假手术组）、IR1组（复苏后3h组）、IR2组（复苏后6h组）、IR3组（复苏后12h组）、IR4组（复苏后24h组）、P1组（丙泊酚预处理＋复苏后6h组）、P2组（丙泊酚预处理＋复苏后12h组），每组8只。P组自缺血前30min静脉输注丙泊酚1mg／（kg·min），Con组及IR组按0．1mL／（kg·min）速率输注乳酸钠林格液，然后开始I／R模型制作。在相应的时间点处死大鼠，采用酶生化法测定各组大鼠血清中丙氨酸氨基转移酶（ALT）和天门冬氨酸氨基转移酶（AST）表达；采用免疫组化法观察各组大鼠肝细胞Bcl-2、Bax和核因子-κB（NF—κB）表达情况。结果IR组ALT和AST表达较Con组明显升高（P〈0．05），IR1组ALT和AST表达最高；与Con组比较，IR2组、IR3组和IR4组肝细胞抑凋亡蛋白Bcl-2表达明显降低（P〈0．05），IR1组、IR2组、IR3组和IR4组促凋亡蛋白Bax表达明显升高（P〈0．05），肝细胞NF—κB表达明显增加（P〈0．05）；与IR组比较，P1组和P2组ALT和AST表达明显降低（P〈0．05），肝细胞抑凋亡蛋白Bcl-2表达明显增多（P〈0．05），促凋亡蛋白Bax表达明显下降（P〈0．05），肝细胞NF—κB表达也明显减少（P〈0．05）。结论心肺复苏后大鼠存在肝细胞损伤和凋亡，其中Bcl-2／Bax比例失衡、NF—κB的激活可能在肝细胞损伤中起重要作用；丙泊酚预处理可有效降低Bax的表达，增加Bcl-2的表达，从而抑制肝细胞的凋亡，发挥肝细胞保护作用。
Objective To study the influence of propofol preconditioning on hepatocyte injury in the rats after cardiopulmonary resuscitation. Methods The asphyxia （succinylcholine） combined with 0. 5 mol/L ice potassium cardioplegia induced cardiac arrest in rats, and lasted 5 rain, then started to cardiopulmonary resuscitation. 56 health Sprague Dawley male rats were divided into 7 groups： Con group （sham operation group）, IR1 group （3 h after recovery）, IR2 group （6 h after recovery）, IR3 group （12 h after recovery） , IR4 group （24 h after recovery） , P1 group （propofol preconditioning ＋ 6 h after recovery）, P2 group （propofol preconditioning ＋ 12 h after recovery）, 8 rats in each group. Since 30 min before ischemia, P group was infused propofol by 1 mg/（kg·min）, Con group and IR group was infused lactated Ringer＇s solution by 0.1 mL/（ kg·min） rate, and then I/R models were made. At corresponding time points, rats were sacrificed, and alanine aminotransferase （ALT） and aspartate aminotransferase （AST） content were measured by using enzyme biochemical determination; the expression of Bcl - 2, Bax and nuclear factor - κB （ NF - κB） by immunohistochemical method in rat liver cells. Results Compared with Con group, ALT and AST in IR group increased significantly （P 〈 0.05 ）, ALT and AST expression reached the maximum in IR1 group; Compared with Con group, liver ceU apoptosis protein Bcl - 2 expression was significantly decreased in IR2 group, IR3 group and IR4 group （ P 〈 0. 05 ） ; Bax expression was significantly increased in IR1 group, IR2 group, IR3 group and IR4 group （ P 〈 0.05 ） , liver cell NF - κB expression was significantly increased （ P 〈 0.05 ） ; Compared with IR group, ALT and AST expression decreased significantly in P1 and P2 group （P 〈 0.05 ） , Bcl - 2 expression was significantly increased （ P 〈 0.05 ）, Bax expression was significantly decreased （ P 〈 0. 05 ） , NF - κB expression in liver cells also dec
出处
《中国急救医学》
CAS
CSCD
北大核心
2012年第11期1009-1011,共3页
Chinese Journal of Critical Care Medicine
