阿片受体在异氟醚延迟预处理减轻兔心肌缺血再灌注损伤中的作用  

Role of opioid receptors in protective effects of isoflurane-induced delayed preconditioning against myocardial ischemia-reperfnsion injury in rabbits

作　　者：冉珂[1] 段开明[2] 朱蓉[1] 李利文[1] 阮文燕[1] 徐军美 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：《中华麻醉学杂志》2009年第6期547-549,共3页Chinese Journal of Anesthesiology

基　　金：湖南省自然科学基金资助项目（03JJY3053）;湖南省科技厅资助项目（2007FJ3015）

摘　　要：目的探讨阿片受体在异氟醚延迟预处理减轻兔心肌缺血再灌注损伤中的作用。方法健康雄性新西兰大白兔40只，体重2．0～2．5kg，采用结扎左冠状动脉前降支40min，再灌注120min的方法制备心肌缺血再灌注损伤模型，随机分为4组（n=10）：假手术组（S组）吸入纯氧2h，24h后仅动脉下穿线不结扎；心肌缺血再灌注组（IR组）吸入纯氧2h，24h后行心肌缺血再灌注；异氟醚延迟预处理组（I组）吸入2％异氟醚2h，24h后行心肌缺血再灌注；阿片受体阻断剂＋异氟醚延迟预处理组（N组）静脉注射纳洛酮6mg／kg后10min，吸入2％异氟醚2h，24h后行心肌缺血再灌注。于再灌注120min时取心脏，计算心肌缺血面积和梗死面积，测定磷酸化p38MAPK蛋白表达水平，观察心肌细胞超微结构。结果S组心肌细胞完整，排列整齐，线粒体形态正常，糖原丰富；IR组和N组心肌细胞水肿，心肌纤维排列紊乱，线粒体、内质网膜水肿，空泡化；I组心肌细胞水肿程度减轻，心肌纤维排列较完整，线粒体轻度水肿。与IR组比较，I组心肌梗死面积减小，磷酸化p38MAPK蛋白表达下调（P〈0．05），N组上述指标差异无统计学意义（P〉0．05）。结论阿片受体参与异氟醚延迟预处理减轻兔心肌缺血再灌注损伤。Objective To investigate the role of opioid receptors in the protective effects of isofluraneinduced delayed preconditioning against myocardial ischemia-reperfusion （I/R） injury in rabbits. Methods Forty male New Zealand white rabbits weighing 2.0-2.5 kg were randomly assigned into 4 groups （ n = 10 each） ： group Ⅰ sham operation （S）; groupⅡ I/R; group Ⅲ isoflurane ＋ I/R （Iso）and group Ⅳ Iso ＋ naloxone ＋ I/R （Nal）. Myocardial I/R was induced by 40 min occlusion of left anterior descending branch （LAD） of coronary artery followed by 120 rain repeffusion. In group Ⅲ （Iso） 2% isoflurane in 100% O2 was inhaled for 2 h and I/R was produced 24 h later. In group Ⅳ （Nal） naloxone 6 mg/kg was given iv 10 min before 2 h of 2% isoflurane inhalation and I/R was produced 24 h later. At the end of 120 min reperfusion, infarct size （IS） and area at risk （AAR） were determined by Evan＇s blue and TTC staining. Myocardial uhrastructure was examined by electron microscopy. The phosphorylated p38MAPK protein expression in myocardium was determined by Western blot. Results The IS was significantly smaller in group Iso （Ⅲ ） （19.7% ±2.8%） than in I/R group （ Ⅱ ） （37.8 % ±1.7 % ） （ P 〈 0.05 ） . The phosphorylated p38MAPK protein expression in myocardium was significantly lower in group Iso than in group I/R. Microscopic examination showed less myocardial damage in Iso group than in group I/R. The protective effects of delayed preconditioning by isoflurane was prevented by naloxone pretreatment. Conclusion Opioid receptors may be involved in the protective effects of delayed preconditioning by isoflurane against myocardial I/R injury.

关 键 词：受体 阿片样 异氟醚 缺血预处理 心肌 心肌再灌注损伤 

分 类 号：R614[医药卫生—麻醉学]