异氟醚预处理和异丙酚预处理对大鼠心肌缺血再灌注损伤的影响  

Effects of preconditioning with isoflurane and propofol on myocardial ischemia-reperfusion injury in rats

作　　者：陶星[1] 李彦平[1] 田鸣[1] 槐庆元[1] 李树人[1] 

机构地区：[1]首都医科大学附属北京友谊医院麻醉科,100050

出　　处：《中华麻醉学杂志》2010年第2期227-230,共4页Chinese Journal of Anesthesiology

摘　　要：目的评价异氟醚预处理和异丙酚预处理对大鼠心肌缺血再灌注损伤的影响。方法雄性Wistar大鼠36只，体重250—300g，随机分为4组（n=9）：缺血再灌注组（I／R组）、异氟醚预处理组（I组）、异丙酚预处理组（P组）和异氟醚预处理联合异丙酚预处理组（I＋P组）。I组异氟醚预处理方法：吸入1．6％异氟醚10min，停止吸入5min，共重复2次；P组异丙酚预处理方法：静脉输注异丙酚37．5mg·kg^-1·h^-1 10min，停止输注5min，共重复2次；I＋P组同时进行异氟醚预处理和异丙酚预处理。预处理后立即结扎左冠状动脉前降支60min，随后松开进行再灌注，I／R组只进行缺血再灌注。再灌注120min时每组取1只大鼠，取心肌组织，透射电镜下观察心肌细胞超微结构；各组其余大鼠处死后，取左心室，采用TUNEL法测定心肌细胞凋亡情况，计算凋亡指数，并测定心肌细胞线粒体活性氧（ROS）水平。结果各组均可见凋亡小体，I组、P组和I＋P组心肌损伤程度轻于I／R组。与I／R组比较，I组、P组和I＋P组心肌细胞凋亡指数和ROS水平降低（P〈0．05），而I组、P组和I＋P组间上述指标比较差异无统计学意义（P〉0．05）。结论异氟醚预处理或异丙酚预处理及两种方法联合应用时减轻大鼠心肌缺血再灌注损伤的效应相似。Objective To evaluate the effects of preconditioning with isoflurane and propofol on myocardial ischemia-reperfusion （I/R） injury in rats. Methods Thirty-six male Wistar rats weighing 250-300 g were randomly divided into 4 groups （n = 9 each）： group Ⅱ I/R; group Ⅱ isoflurane preconditioning （group Ⅰ）; group Ⅲ prepofol preconditioning （group P） and group Ⅳ preconditioning with isoflurane and propofol （group I ＋ P）. The animals were anesthetized with intraperitoneal urethane. The trachea was intubated. The animals were mechanically ventilated. In group Ⅱ and Ⅳ the animals received 2 episodes of 10 min 1.6% isoflurane inhalation at 5 min intervals before I/R; in group Ⅲ and Ⅳ the animals received 2 episodes of 10 min iv propofol infusion at 37.5 mg·kg^-1·h^-1 at 5 min intervals before I/R. Preconditioning with isoflurane and propofol was performed simultaneously in group I ＋ P （ Ⅳ ）. Myocardial I/R was produced by 60 min occlusion of left anterior descending coronary artery followed by 120 min reperfusion. The animals were sacrificed at the end of 120 min reperfusion and the hearts were removed for microscopic examination with transmission electron microscope, detection of myocyte apoptosis by TUNEL staining and determination of mitochondrial ROS level by fuorescence staining. Results Cardiomyocyte apoptosis was detected by transmission electron microscopy. Apoptosis index and mitochondrial ROS level were significantly lower in group I, group P and group I ＋ P than in group I/R, but no difference was found among the 3 preconditioning groups. Conclusion The protection provided by preconditioning with isoflurane or propofol or isoflurane ＋ propofol against myocardial I/R is comparable.

关 键 词：异氟醚 二异丙酚 缺血预处理 心肌再灌注损伤 

分 类 号：R96[医药卫生—药理学]