瑞芬太尼和异丙酚对健康志愿者体外静脉血中性粒细胞呼吸爆发的影响  

Effects of remifentanil and propofoi on respiratory burst of polymorphonuclear leukocytes in venous blood of healthy adult volunteers in vitro

作　　者：李新友[1] 屠伟峰[1] 郄文斌[1] 杨传红[2] 戴建强[1] 王捷[2] 

机构地区：[1]广州军区广州总医院全军临床麻醉中心,510010 [2]广州军区广州总医院医学实验科,510010

出　　处：《中华麻醉学杂志》2008年第11期997-1000,共4页Chinese Journal of Anesthesiology

基　　金：广东省医学科研基金资助项目（A2001518）

摘　　要：目的评价瑞芬太尼和异丙酚对健康志愿者体外静脉血中性粒细胞（PMNs）呼吸爆发的影响。方法健康志愿者12名，年龄20～40岁，体重55～65kg，取肘静脉血5ml抗凝。采用正交实验设计确立实验因素为瑞芬太尼和异丙酚；实验水平数为5水平，即瑞芬太尼空白对照、溶媒（甘氨酸）对照、瑞芬太尼5、50、500ng／ml和异丙酚空白对照、溶媒（脂肪乳）对照、异丙酚5、50、500μg／ml，用正交表k（5^0），观察药物对静息状态和脂多糖（LPS）激活状态下PMNs呼吸爆发的影响，静息状态的PMNs不用LPS进行刺激，按实验设计方案加入相应药物孵育3h；激活状态的PMNs根据用药时机分为预防性用药和治疗性用药，预防性用药加入相应药物孵育1h，再加入LPS（终浓度1μg／ml）孵育2h；治疗性用药首先加入LPS（终浓度1μg／ml）孵育1h，再加入相应药物孵育2h。结果瑞芬太尼50ng／ml可增强静息状态下PMNs的呼吸爆发；各剂量瑞芬太尼治疗性用药均可增强LPS激活状态下PMNs的呼吸爆发（P〈0．05），预防性用药对PMNs的呼吸爆发无影响（P〉0．05）。各剂量异丙酚及脂肪乳可降低静息和LPS激活状态下PMNs的呼吸爆发（P〈0．05），但各剂量异丙酚与脂肪乳比较差异无统计学意义（P〉0．05）。瑞芬太尼和异丙酚对静息状态下和激活状态下PMNs呼吸爆发的影响没有交互作用。结论瑞芬太尼对PMNs呼吸爆发的影响可能与PMNs所处的状态、用药剂量及用药时机有关；异丙酚的溶媒可抑制PMNs的呼吸爆发，而异丙酚本身无作用，且这种抑制作用与PMNs所处的状态及用药时机无关；瑞芬太尼和异丙酚对PMNs呼吸爆发的影响没有交互作用。Objective To evaluate the effects of remifentanil and propofol on the respiratory burst of polymorphonuclear leukocytes （PMNs） in the venous blood o（ healthy adult volunteers in vitro. Methods The ulnar vein blood 5 ml was obtained from 12 healthy adult volunteers of both sexes, aged 20-40 yr, weighing 55- 65 kg, and anticoagulated with EDTA. The experiment was divided in 2 parts： remifentanil and propofol. Each part was divided into 5 groups： Drug Level Ⅰ Ⅱ Ⅲ Ⅳ Ⅴ Remifentanil Blank control Solvent（glycine） control 5 ng/ml 50 ng/ml 500 ng/ml Propofol Blank control Solvent（intralipid） control 5μg/ml 50 μg/ml 500 μg/ml Each group was again divided into static group and LPS group and the latter was further divided into drug-pretreated group and drug-treat group. Blood samples were incubated with the drug for 3 h at 37μ in 95% air-5% CO2. Six G of rhodamine was added to 200 μ of each sample which was incubated for 10 min, then phorbol ester was added and 200 μl of each sample was incubated for another 30 rain. Then 4 ml of FACSlyse was added to each sample to break down RBC. The pellet was resuspended in 0.01 mol/L phosphate-buffered saline （PBS） 500 μl containing 1% paraformaldehyde after centrifugation and the respiratory burst of PMNs was determined using flow cytometry. Results Remifentani] 50 ng/ml could enhance the respiratory burst of PMNs in the static state. Remifentanil at each dose could enhance the respiratory burst of LPS-activated PMNs in drug-treat group （ P 〈 0.05）, but it had no effect on the respiratory burst of PMNs in drug-pretreated group （P 〉 0.05）, Propofol at each dose and intralipid could reduce the respiratory burst of PMNs in the static and LPS-activated state （ P 〈 0.05 ）, but there was no significant difference between propofol at each dose and intralipid（ P 〉 0.05 ）. The effects of remifentanil and propofol on the respiratory burst of PMNs had no interaction whether in the static state or in the LPS-activated state.

关 键 词：哌啶类 二异丙酚 中性白细胞 呼吸爆发 体外研究 

分 类 号：R96[医药卫生—药理学]