吗啡预处理对大鼠体外工作心脏的保护作用  

Protective Effect of Morphine Preconditioning on Isolated Working Rat Heart

作　　者：王建堂[1] 杜心灵[1] 夏家红[1] 朱艳萍[2] 

机构地区：[1]华中科技大学同济医学院附属协和医院心脏外科,武汉430022 [2]山东省聊城市人民医院儿科,聊城252000

出　　处：《华中科技大学学报（医学版）》2005年第5期588-590,600,共4页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

摘　　要：目的研究吗啡预处理对大鼠体外工作心脏缺血再灌注损伤的保护作用,并探讨其机制。方法50只雄性大鼠随机分为5组,每组10只,建立体外工作心脏模型,用4℃St.ThomasⅡ停搏液诱导心脏停搏30 min,心脏停搏前采用5 min缺血,10 min再灌注的缺血预处理或0.3μmol/L吗啡灌注两种处理方法,并分别用纳洛酮和格列苯脲对吗啡的作用进行干预,观察心脏复灌后心功能指标、心肌酶值变化、心肌超微结构改变及心肌含水率。结果吗啡组和缺血预处理组在心排血量恢复率、左室收缩压力变化速度、左室发展压恢复率及心肌乳酸脱氢酶(LDH)均优于对照组(均P<0.05);吗啡组和缺血预处理组心肌含水率明显低于对照组(P<0.05);心肌线粒体等超微结构损伤明显减轻;纳洛酮和格列苯脲可以完全阻断吗啡预处理的心肌保护作用。结论吗啡预处理可以产生与缺血预处理同样的心肌保护作用。吗啡是通过心脏局部的阿片受体及心肌细胞ATP敏感性钾通道介导产生心肌保护作用。Objective To study the protective effect of morphine preconditioning on the isolated working rat heart and its mechanism. Methods Fifty male Wistar rats were randomly divided into 5 groups with 10 rats in each group. The experimental protocol consisted of 5-min myocardial ischemia and 10-min reperfusion or 15-min perfusion of K-H buffer containing morphine 0.3μmol/L followed by 30-min St. Thomas Ⅱospital cardioplegia arrest, and glibenclamide and naloxone have been administered to interfere in the effect of morphine on myocardium. The recovery of the left ventricular function, release of myocardial enzymes, ultrastructure of myocardium and myocardial water content were assessed before and after ischemia. Results The hearts perfused by morphine or preserved by ischemic preconditions before cardioplegia arrest had better recovery of cardiac function and lower release of LDH than control, with myocardial tissue being of general normal structure and lower water content. The protective effects of morphine on myocardia were eliminated completely by naloxone or glibenclamide. Conclusion Morphine perfusion before cardioplegia arrest can protect myocardia, which is probably mediated by local opioid receptor and KATP channels in myocytes.

关 键 词：吗啡 缺血预处理 心肌保护 

分 类 号：R654.2[医药卫生—外科学]