异氟醚预处理延迟相对兔心肌缺血再灌注损伤的保护作用  

Protective effects of isoflurane delayed preconditioning on rabbit myocardium after ischemic-reperfusion

作　　者：冉珂[1] 段开明[2] 邹定全[1] 卢向航[1] 张燕玲[1] 常业恬[1] 

机构地区：[1]中南大学湘雅二医院麻醉科,湖南长沙410011 [2]中南大学湘雅三医院麻醉科

出　　处：《临床医学》2007年第10期69-72,共4页Clinical Medicine

基　　金：湖南省自然科学基金项目(03JJY3053)

摘　　要：目的探讨不同浓度异氟醚预处理延迟相对兔心肌缺血再灌注损伤的影响。方法30只健康新西兰雄性大白兔随机分成三组:1组:缺血再灌注组,行冠状动脉左前降支阻断40 min,再灌注120 min;2组:1.0%异氟醚预处理组,予以1.0%异氟醚+100%氧气持续吸入2 h后停止吸入异氟醚,于24 h后同1组处理;3组:2.0%异氟醚预处理组,予以2.0%异氟醚+100%氧气持续吸入2 h后停止吸入异氟醚,于24 h后同2组处理。各组分别于左冠前降支阻断前20 min(T1)、左冠前降支阻断20 min(T2)、左冠前降支阻断40 min(T3)、心肌再灌注1 h(T4)心肌再灌注2 h(T5)五个时点取颈内动脉血测定肌钙蛋白(cTnI)浓度。再灌注结束后观察心肌超氧化物歧化酶(SOD)活性、丙二醛(MDA)含量及心肌细胞超微结构的变化。用伊文思蓝和TTC染色法测心梗面积,同时观察心肌细胞超微结构变化。结果①2组和3组肌钙蛋白增高程度低于1组(P<0.05)。②心肌梗死面积:2组(24.2%±2.1%)和3组(19.7%±2.8%)低于1组(37.8%±1.7%)(P<0.05)。③心肌细胞电镜观察显示预处理组心肌细胞损伤轻于对照组。④2组和3组MDA较1组降低(P<0.05),SOD较1组增高(P<0.05)。结论异氟醚预处理延迟相对兔心肌缺血再灌注损伤有保护作用。Objective To investigate the protective effects of isoflurane delayed preconditioning on myocardial ischemia reperfusion injury in rabbit myocardium. Methods Thirty New Zealand male white rabbits were randomly assigned to 3 groups ： control group, 1.0% isoflurane group and 2.0% isoflurane group. Group 2 and group 3 were respectly exposed to 1.0% isoflurane - 100% oxygen and 2.0% isoflurane - 100% oxygen for 2 h. Group 1 exposed 2 h to 100% oxygen served as untreated controls. Twenty - four hours laterall rabbits underwent 40 min of coronary occlusion followed by 2 h of reperfusion. Blood samples were taken from arterial line at 20 min before occlusion （T1） ,20 min after occlusion（T2） ,40 min after occlusion （T3）, 1 h after reperfusion（T4） and 2 h after reperfusion（ T5 ） for determination of plasma cTnI levels. At the end of the reperfusion, infarct size （IS） and area at risk （AAR） were defined by Evans and TTC staining. Results The cTnI levels of group 2 and group 3 were significantly lower than that of group 1 （ P 〈 0.05 ）. Isoflurane significantly （ P 〈 0.05 ） reduced infarct size （ 24.2% ± 2.1% ） in group 2, （ 19.7% ±2.8% ） in group 3 of the left ventricular area at riskas compared with control （37.8% ± 1.7% ） in group 1. The injury of group 1 was worse than that of group 2 and group 3 from the changes of the cellular structure under light microscope. Group 2 and group 3 had a lower levels of MDA and also had a higher level of SOD. Conclusion Isoflurane preconditioning induces late cardioprotection against postischemic reperfusion injury in rabbits.

关 键 词：异氟醚 延迟相预处理 心肌保护 缺血再灌注损伤 

分 类 号：R96[医药卫生—药理学]