腺苷和芬太尼预处理减轻急性失血性休克兔心肌损伤  

Adenosine or fentanyl pretreatment attenuates myocardial injury in acute hemorrhagic shock rabbits

作　　者：刘晓峰[1] 柴伟[1] 杨永慧[1] 于代华[1] 彭德民[1] 赵晖[1] 姚立农[1] 

机构地区：[1]第四军医大学附属唐都医院麻醉科,西安市710038

出　　处：《实用医学杂志》2007年第14期2132-2134,共3页The Journal of Practical Medicine

摘　　要：目的:观察腺苷和芬太尼预处理对急性失血性休克家兔心肌缺血损伤的影响。方法:24只家兔随机分为对照组(C组)、腺苷预处理组(A组)和芬太尼预处理组(F组)。按Wigger′s改良法制作家兔失血性休克模型。放血前15min各组分别给予等容量生理盐水、腺苷(1.5mg/kg)和芬太尼(25g/kg)。放血使平均动脉压(MAP)降至约40mmHg。持续监测MAP、左室压(LVP)、左室收缩压最大上升速率(+dp/dtmax)和下降速率(-dp/dtmin)。放血前、放血后60min和90min抽血测定血清心肌肌钙蛋白I(cTn-I)浓度,实验结束时取心尖部组织行电镜检查。结果:各组放血后MAP、LVP、+dp/dtmax和-dp/dtmin均明显下降,但A组和F组明显高于C组(P<0.05或P<0.01)。cTn-I在放血后60min和90min与放血前比较均明显增高(P<0.01),A组和F组增高程度低于C组(P<0.01),A组和F组之间差异无显著性(P>0.05)。电镜检查发现A组和F组心肌损伤较C组减轻。结论:腺苷和芬太尼预处理均能减轻家兔急性失血性休克后的心肌损伤。Objective To investigate the effects of adenosine or fentanyl pretreatment on myocardial injury in acute hemorrhagic shock rabbits. Methods Twenty-four rabbits were randomly assigned to receive saline （group C）, adenosine of 1.5 mg/kg （group A）, or fentanyl of 25 p,g/kg （group F） 15 minutes before bloodletting. The rabbit model of acute hemorrhagic shock was established according to Wigger＇s method. MAP, LYP, ＋dp/dmax and -dp/dtmax were monitored constantly during hemorrhagic shock. Serum cardiac troponin I （eTn-I） levels were determined by chemiluminescence method before, and 60 min and 90 min after bloodletting. Morphological changes in myoeardium were observed by electron microscopy. Results Even though all in three groups were declined obviously after bloodletting, MAP,LVP,＋dp/dtmax and -dp/dtxin were markedly higher in group A and group F than in group C （P 〈 0.05 or P 〈 0.01）. Serum eTn-I levels in all groups were increased significantly after bloodletting （P 〈 0.01） with a high degree in group C （P 〈 0.01） but without difference between group A and group F （P 〉 0.05）. Myocardial injury was alleviated in group A and group F as compared with group C. Conclusion Adenosine or fentanyl pretreatment can attenuate myocardial injury in acute hemorrhagic shock.

关 键 词：休克 出血性 兔 腺苷 芬太尼 预处理 肌钙蛋白I 

分 类 号：R614[医药卫生—麻醉学] R459.7[医药卫生—外科学]