麻醉剂量异丙酚对大鼠局灶性脑缺血再灌注损伤的保护作用(英文)  

Protective effects of propofol on focal ischemia-reperfusion injury in rats

作　　者：蔡英敏[1] 胡海涛[1] 王美纳[1] 马小亚[1] 

机构地区：[1]西安交通大学医学院第二附属医院麻醉科,陕西省西安市710004

出　　处：《中国临床康复》2006年第4期175-177,共3页Chinese Journal of Clinical Rehabilitation

基　　金：陕西省科技攻关项目(2003K10-G86);国家自然科学基金(30070731)~~

摘　　要：背景:在临床实践中异丙酚可以收缩脑血管,降低脑血流量,减少脑代谢耗氧量,从而达到降低颅压的目的。实验证实异丙酚对活性氧损伤的内皮细胞具有良好的保护作用,对实验性大鼠脑缺血的神经损害有保护作用。目的:观察异丙酚对大鼠脑缺血再灌注损伤的保护作用及其机制。设计:随机对照实验。单位:西安交通大学医学院第二附属医院麻醉科。材料:实验于2004年西安交通大学医学院药理实验室完成。选取健康清洁级SD雄性大鼠40只,鼠龄三四个月,体质量200～300g。随机分为模型组、对照组、尼莫地平组及异丙酚组,每组10只。方法:分别在大鼠腹腔内注射氯胺酮及异丙酚,待其翻正反射消失后,分离并结扎颈外动脉,对照组仅将尼龙线放在颈外动脉残端处,但不结扎。模型组:在缺血前10min腹腔注入生理盐水10mL;对照组:在术毕后腹腔注入生理盐水10mL;尼莫地平组:在缺血前10min腹腔注入10g/L尼莫地平1mg/kg;异丙酚组:在缺血前10min腹腔注入10g/L异丙酚110mg/kg。除对照组外其余各组缺血3h再灌注3h,眼眶取血,开颅取脑,观察麻醉剂量异丙酚对脑缺血再灌注损伤的保护作用。主要观察指标:大鼠脑梗死范围,脑组织含水量,血清乳酸脱氢酶、肌酸激酶,脑组织超氧化物歧化酶活性,丙二醛含量,钙离子含量,电镜下脑细胞超微结构。结果:①异丙酚组梗死范围明显小于模型组[(10.45±3.65,19.68±4.03)%,(t=3.493,P<0.01)]。②异丙酚组肌酸激酶含量明显低于模型组[(471±200,1930±917)IU/L,(t=3.493,P<0.01)];乳酸脱氢酶含量为(8240±2580)U/L,与模型组[(15470±2680)U/L]比较差异有显著性意义(t=3.441,P<0.01);异丙酚组脑组织含水量明显低于模型组[(78.2±2.4,82.9±2.9)%,(t=3.321,P<0.01)]。③异丙酚组大鼠死亡率为13.6%,与模型组47.6%比较有显著性差异(t=6.21,P<0.05)。④异丙酚组超氧化物歧化酶活性为(1690±780)U/g,与模型组(830BACKGROUND： In clinical, propofol can contract cerebral vessels, decrease cerebral blood flow, decrease brain metabolic oxygen consumption, which can decrease pressure in brain. Studies prove that propofol can protect endothelial cell that may be injuried by active oxygen injury and also decrease nerves injury of experimental rats with cerebral ischemia. OBJECTIVE： To investigate the protective effects of propofol on cerebral ischemia-reperfusion injury in rat and its mechanism. DESIGN： Randomized and controlled study. SETTING： Anesthesiological Department of the Second Affiliated Hospital of Xi＇an Jiaotong University. PARTICIPANTS： The experiment was conducted at Pharmacological Laboratory of Medical College of Xi ＇an Jiaotong University in 2004. Totally 40 healthy male SD rats, aged 3-4 months, weighting 200-300 g, were divided randomly into four groups： Model group, control group, nimodipine group and propofol group, with 10 in each group. METHODS： The rats were anesthetized by intraperitoneal methods with ketamine and propofol separately. When righting reflex was abolished, external carotid artery was separated and ligated. A nylon thread was put at the stump site of external carotid artery without ligation. Model group： 10 mL nornlal saline was injected into intraperitone in 10 minutes before ischemia. Control group： 10 mL normal saline was injected into intraperitone at the end of operation. Nimodipine group： 10 g/L nimodipine （1 mg/kg） was injected into intraperitone in10 minutes before ischemia, propofol group： 10 g/L propofol （110 mg/Kg） was injected into intraperitone in 10 minutes before ischemia. When ischemia was lasted for 3 hours, nylon thread was withdrawed for reperfusion. When reperfusion was lasted for 3 hours, blood sampies were obtained from orbit. Skulls were opened and brains were removed. Effect of propofol on cerebral ischemia-reperfusion injury was observed. MAIN OUTCOME MEASURES： Infarction area, cerebral water content, serum lactate dehydro

关 键 词：脑缺血 异丙酚 剂量 麻醉 再灌注损伤 保护作用 局灶性脑缺血 

分 类 号：R743.31[医药卫生—神经病学与精神病学] R614[医药卫生—临床医学]