丙泊酚和芬太尼预处理减轻急性失血性休克兔心肌损伤的观察  

Propofol and fentanyl preconditioning 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] 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：《临床麻醉学杂志》2008年第3期236-238,共3页Journal of Clinical Anesthesiology

摘　　要：目的观察丙泊酚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只家兔随机均分为丙泊酚预处理组(P组)、芬太尼预处理组(F组)和对照组(C组)。按Wigger’s改良法制作家兔失血性休克模型。放血前各组分别给予等容量丙泊酚5mg/kg、芬太尼25μg/kg和生理盐水。放血使MAP降至约40mmHg。持续监测MAP、左室压(LVP)、左室收缩压最大上升和下降速率(±dp/dtmax)。放血前、放血后60min和90min抽血测定血清心肌肌钙蛋白I(cTnI)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均明显下降,但P组和F组明显高于C组(P<0·05或P<0·01)。cTnI在放血后60min和90min与放血前比较均明显增高(P<0·01),P组和F组增高程度低于C组(P<0·01),P组和F组之间差异无统计学意义。电镜检查发现P组和F组心肌损伤较C组减轻。结论丙泊酚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 propofol and fentanyl preconditioning on myocardial injury in acute hemorrhagic shock rabbits. Methods Twenty-four healthy white rabbits were equally randomized into propofol preconditioning group（P）, fentanyl preconditioning group（F） and control group （C）. Acute hemorrhagic animal model was established according to Wigger＇ s method. Before bloodletting,The same volume of propofol （5 mg/kg）, fentanyl （25μg/kg） and saline were given tO group P,group F and group C, respectively. MAP, LVP, ±dp/dtmax were monitored constantly during 90 min of hemorrhagic shock. Arterial blood samples were taken before bloodletting, at 60 min and 90 min during shock for determination of serum cardiac troponin I （cTnI） by chemiluminescence method. Morphological changes of the heart were observed by electron microscopy. Results MAP, LVP and ±dp/dtmax were decreased after bleeding but recovered to a higher level in group P and F compared with those in group C （P〈0.01） during 90 min shock. The serum concentrations of cTnI increased significantly in all groups after bleeding compared with those before （P〈O. 01）. But cTnI values in group P and F were lower than those in group C （P〈O. 01）. Morphological changes of the myocardium showed that myocardial injury was less in group P and F than that in group C. Conclusion Propofol and fentanyl preconditioning can attenuate myocardial injury in acute hemorrhagic shock.

关 键 词：丙泊酚 芬太尼 预处理 失血性休克 肌钙蛋白I 

分 类 号：R96[医药卫生—药理学]