摘要
目的观察瑞芬太尼后处理对兔离体心脏的保护效应,并与瑞芬太尼预处理进行比较。方法建立兔离体心脏缺血再灌注模型,按照体重将新西兰兔随机分为3组:模型组、瑞芬太尼预处理组(RPC)与瑞芬太尼后处理组(RPO)。模型组用全心缺血30 min,再灌注120 min;RPC组在全心缺血30 min前,给予瑞芬太尼60μg·L^(-1)缓冲液进行预处理;RPO组在全心缺血30 min后,给予瑞芬太尼60μg·L^(-1)缓冲液进行后处理。观察比较各组的心率(HR),左室发展压(LVDP),左室压力上升最大变化速率(+dp/dt_(max))和左室压力下降最大变化速率(-dp/dt_(max)),检测冠脉流出液中肌酸激酶(CK)、乳酸脱氢酶(LDH)含量,比较心肌梗死面积的变化。结果在再灌注30 min时,RPC组、RPO组的LDVP分别为(39.95±8.18),(49.55±10.38)mm Hg,显著高于模型组的(27.21±10.26)mm Hg;在再灌注90 min时,RPC组、RPO组的LDH分别为(90.70±4.31),(88.75±7.14)U·L^(-1),显著低于模型组的(109.54±11.38)U·L^(-1);RPC组、RPO组的心肌梗死面积分别为(21.54±5.28)%,(17.82±6.39)%,显著低于模型组的(59.49±9.94)%。RPC组和RPO组与模型组的以上指标比较,差异均有统计学意义(均P<0.05)。结论 RPO能改善缺血再灌注损伤兔心肌收缩、舒张功能,减少心肌梗死面积,对心肌有保护作用。
Objective To investigate the protective effects of remifentanil postconditioning on isolated rabbit hearts and compare the effects of remifentanil postconditioning with remifentanil preconditioning. Methods The ischemia reperfusion model of isolated rabbit heart was set up,24 rabbits were randomly divided into 3 groups： model group,remifentanil preconditioning（ RPC）,remifentanil postconditioning（ RPO）. In model group,the hearts was induced by 30 min of global ischemia and 120 min of reperfusion; in RPC group,the hearts were subjected to preconditioning by 60 μg · L^-1 remifentanil buffer before 30 min of global ischemia; in RPO group,the hearts were subjected to postconditioning by 60 μg·L^-1 remifentanil buffer after 30 min of global ischemia. The heart rate（ HR）,left ventricular developed pressure（ LVDP）,maximum change rate of left ventricular pressure rise（ ＋ dp/dtmax） and the maximum change rate of left ventricular pressure drop（-dp/dtmax）,contents of lactate dehydrogenase（ LDH） and creatine phosphokinase（ CK） in the liquid of coronary were measured. The myocardial infarct size was caculated.Results At 30 min after reperfusion,LDVP in RPC group and RPO group were（ 39. 95 ＋ 8. 18）,（ 49. 55 ＋ 10. 38） mm Hg,significantlyhigher than the model group of LDVP（ 27. 21 ＋ 10. 26） mm Hg. At 90 min after reperfusion,LDH in RPC group and RPO group were（ 90. 70 ＋ 4. 31）,（ 88. 75 ＋ 7. 14） U·L^-1,significantly lower than the model group（ 109. 54 ＋11. 38）U·L^-1. Myocardial infarction area of RPC group and RPO group were（ 21. 54 ＋ 5. 28） %,（ 17. 82 ＋ 6. 39） %,the area of myocardial infarction was significantly lower than that of model group（ 59. 49 ＋ 9. 94） %. Comparison between RPC group,RPO group and model group,the differences were statistically significant（ all P〈0. 05）. Conclusion Remifentanil postconditioning can protect the rabbit heart from ischemia reperfusion injury by improving myocardial systolic-diastolic function
作者
郑君
钱金桥
李俊英
邓磊
ZHENG Jun1, QIAN Jin -qiao2, LI Jun -ying1, DENG Lei1(1. Emergency Medical Center, Sichuan Provincial People ＇ s Hospital, Chengdu 610072, China ; 2. Department of Anesthesiology, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Chin)
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2018年第9期1064-1066,1091,共4页
The Chinese Journal of Clinical Pharmacology
基金
国家自然科学基金资助项目(81460044)
云南省中青年学术技术带头人后备人才培养任务基金资助项目(2014HB031)
关键词
后处理
预处理
缺血再灌注损伤
心肌保护
瑞芬太尼
preconditioning
postconditioning
ischemia/reperfusion injury
myocardial protection
remifentanil
