乳化异氟烷预处理对兔心肌缺血再灌注损伤的影响  

Effect of emulsified isoflurane preconditioning on myocardial ischemia-reperfusion injury in rabbits

作　　者：刘训芹[1] 顾尔伟[1] 张雷[1] 张颖[1] 陈立建[1] 朱燕[1] 翟明玉[1] 

机构地区：[1]安徽医科大学第一附属医院麻醉科,合肥市230022

出　　处：《中华麻醉学杂志》2010年第4期480-483,共4页Chinese Journal of Anesthesiology

基　　金：安徽省教育厅重点资助项目（KJ2009A038Z）

摘　　要：目的 评价乳化异氟烷预处理对兔心肌缺血再灌注损伤的影响.方法 雄性新西兰白兔32只,体重2.5～3.0 kg,随机分为4组（n=8）：缺血再灌注组（IR组）、异氟烷预处理组（I组）、乳化异氟烷预处理组（EI组）和脂肪乳组（INT组）.采用结扎左冠状动脉前降支30 min、再灌注180 min的方法建立兔心肌缺血再灌注模型.各组稳定30 min后,I组吸入3%异氟烷,维持呼气末浓度2.20%30 min,洗脱15 min;EI组先以1 ml/s的速率静脉注射8%乳化异氟烷8～10 ml,然后静脉输注6～8 ml·kg-1·h-1,维持呼气末浓度1.28%30 min,洗脱15 min;INT组先以1 ml/s的速率静脉注射30%脂肪乳9 ml,然后静脉输注7 ml·kg-1·h-1持续30 min.于稳定30 min（T0）、缺血前（T1）、缺血即刻（T2）、缺血30 min（T3）、再灌注60 min（T4）、120 min（T5）和180 min（T6）时,记录HR、SP和MAP,计算HR和SP的乘积（RPP）.于T6时抽取动脉血样3 ml,测定血清肌酸激酶（CK）、乳酸脱氢酶（LDH）的活性和IL-6、IL-10的浓度,并测定心肌梗死范围.结果 与T0时比较,T2-6时各组HR、MAP和RPP呈进行性下降（P〈0.05）;四组间HR、MAP和RPP比较差异无统计学意义（P〉0.05）.与IR组比较,I组和EI组心肌梗死范围减小,血清CK、LDH的活性和IL-6浓度降低,L-10浓度升高（P〈O.05）,INT组上述指标差异无统计学意义（P〉0.05）.结论 乳化异氟烷预处理可减轻兔心肌缺血再灌注损伤,机制可能与其抑制炎性反应有关.Objective To evaluate the effect of emulsified isoflurane preconditioning on myocardial iachemia-reperfusion （I/R） injury in rabbits.Methods Thixty-two male New Zealand white rabbits weighing 2.5-3.0 kg were randomly divided into 4 groups（n=8 each）：group Ⅰ I/R;group Ⅱ isoflurane preconditioning （group Ⅰ）;group Ⅲ emulsified isoflurane preconditioning （group EI） and group Ⅳ intralipid （group INT）.Myocardial I/R was induced by 30 min occlusion of left anterior descending branch of coronary artery followed by 180 min of reperfusion.After 30 min of post-preparation equilibration.the animal inhaled 3%isoflurane for 30 min followed by 15 min washout in group Ⅰ（group Ⅱ）;8% emulsified isoflurane 8-10 ml was injected iv at 1 ml/s followed by continuous infusion at 6-8 ml·kg-1·h-1,maintaining end-tidal isoflurane concentration at 1.28% for 30 min in group EI （groupⅢ）;30% intralipid 9 ml was injected iv at 1 ml/s fullowed by continuous infusion at 7 ml·kg-1·h-1 for 30 min in group INT （group IV）.HR and BP were monitored and recorded at 30 min of post-preparatory equilibration（T0）,before ischemia（T1）,at the beginning of ischemia（T2）,at 30 min ofischemia（T3）,60,120 and 180 min of reperfnsion（T4,5,6）.HR-SP product （RPP） was calculated.Infarct size （IS） was determined by TIC staining.Blood samples were taken from carotid artery at T6 for determination of serum CK and LDH activities and IL-6 and IL-10 concentrations.Results HR,MAP and RPP were decreasing during T2-6, but there was no significant difference in HR, MAP and RPP among the 4 groups.The infarct size was signigicantly smaller, serum CK and LDH activities and IL-6 concentration were significantly lower while serum IL-10 concentration was significantly higher in group I and EI than in group I/R and INT.Conclusion Emulsified isoflurane preconditioning can attenuate myocardial I/R injury by inhibiting inflammatory response.

关 键 词：异氟醚 脂肪乳剂 静脉注射用 缺血预处理 心肌再灌注损伤 

分 类 号：R614[医药卫生—麻醉学]