异氟醚延迟相预处理对兔心肌缺血-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] 李辉[1] 明豫军[1] 常业恬[1] 

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

出　　处：《临床麻醉学杂志》2008年第8期679-682,共4页Journal of Clinical Anesthesiology

基　　金：湖南省自然科学基金项目(NO.03JJY3053)

摘　　要：目的探讨异氟醚延迟相预处理对兔心肌缺血-再灌注损伤的保护及对炎性细胞因子的影响。方法30只健康新西兰雄性大白兔随机均分成三组:缺血-再灌注组(I/R组)、2.0%异氟醚延迟相预处理组(S组)、假手术组(C组)。I/R组吸入100%氧气2h,24h后行左冠状动脉前降支阻断40min,再灌注120min;S组吸入2.0%异氟醚+100%氧气2h,24h后处理同I/R组;C组吸入100%氧气2h,24h后仅行左冠脉套线而不阻断160min,各组分别于阻断前20min(T1)、阻断后20min(T2)、40min(T3)、再灌注1h(T4)、2h(T5)五个时点取颈内动脉血测定血清中肌钙蛋白(cTnI)、白细胞介素10(IL-10)和肿瘤坏死因子α(TNF-α)含量。再灌注结束后观察心肌细胞超微结构的变化,用伊文思蓝和TTC染色法测心肌梗死面积。结果与C组比,I/R组与S组cTnI、IL-10和TNF-α含量均升高(P<0.05),但与I/R组比,S组IL-10明显升高(P<0.05),心肌梗死面积减少(P<0.05),cTnI和TNF-α明显降低(P<0.05)。结论异氟醚延迟相预处理通过调控炎性细胞因子平衡发挥心肌保护作用。Objective To investigate the protective effects of isoflurane delayed preconditioning on myocardial ischemia-reperfusion（l/R） injury. Methods Thirty New Zealand male white rabbits were randomly assigned to three groups, I/R group （I/R）, 2.0% isoflurane group （S） and control group（C）. Group S was exposed to 2.0% isoflurane-100% oxygen for 2 h,and group I/R and C were exposed to 100% oxygen for 2 h. Twenty-four hours later, group I/R and C underwent 40 min of coronary occlusion followed by 2 h of reperfusion. Blood samples were taken from arterial line at 20 min before ocelusion（T1 ） ,20 min after occlusion（T2 ） ,40 min after occlusion（T3 ）, lh after reperfusion （T4） and 2 h after reperfusion（T5 ） for determination of plasma calcitonin I （cTnI）, interlcukin-10 （IL- 10） and tumor necrosis factor-α（TNF-α） levels. At the end of reperfusion, infarct size（IS） and area at risk（AAR） were defined by Evans and TTC staining. Results The cTnI level of group S was significantly lower than that of group I/R （P〈0.05）. Isoflurane significantly （P〈0.05） reduced the infarct size [（19.7±2.8）%] in group S with the left ventricular area at risk as compared with that in group I/R [（37.8±1.7）%]. The injury of group I/R was worse than that of group S according to the changes of cellular structure under light microscope. Group S had a lower level of TNF-α and a higher level of IL-10. Conclusion Isoflurane preconditioning induces late cardioprotection against postischemie 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 细胞因子 

分 类 号：R614.1[医药卫生—麻醉学]