芬太尼联合七氟烷后处理对离体大鼠缺血／再灌注心功能的影响  

The effects of fentanyl combined with sevoflurane postconditioning on myocardial functions of isolated ischemia-reperfused rat heart

作　　者：于静[1] 张冯江[2] 杨美娟[2] 何伟[2] 郁丽娜[2] 严敏[2] 

机构地区：[1]徐州医学院江苏省麻醉学重点实验室,221002 [2]浙江大学医学院附属第二医院麻醉科

出　　处：《国际麻醉学与复苏杂志》2011年第1期27-31,共5页International Journal of Anesthesiology and Resuscitation

基　　金：基金项目：浙江省自然基金杰出青年团队项目（R2090259）;国家自然基金面上项目（30772090）;浙江省科技厅钱江人才计~t]（2007R10034）

摘　　要：目的研究芬太尼联合七氟烷后处理对离体大鼠缺血／再灌注（ischemia／reperfusion，／／R）心脏心功能的影响。方法建立离体大鼠心脏缺血40min，再灌注120min模型。根据再灌注开始10min的不同处理，使用随机数字表法将实验动物随机分为4组（n=10）：I／R对照组（Con），七氟烷后处理组（SPC），芬太尼后处理组（Fent），芬太尼联合七氟烷后处理组（Fent＋SPCo监测左室收缩压（left ventricular systolic pressure，LVSP）、左室发展压（left ventricular developed pressure，LVDP）、左室内压上升最大速率（＋dp／dt）、左室内压下降最大速率（-dp／dt）、心率（HR）以及冠脉流量（coronaryflow，CF）。测定乳酸脱氢酶（lactate dehydrogenase，LDH）释放量和心肌梗死面积。结果SPC组LVSP、LVDP、±dp／dt和cF再灌注各时点均高于Con组（P〈O．05）。Fent组和Fent＋SPC组LVSP、LVDP于再灌注15min较SPC组差异有统计学意义（P〈O．05），随后压力渐下降，再灌注60min之后各时点均较SPC组低（P〈0．05）。HR各组间差异无统计学意义。Fent组和Fent＋SPC组再灌注初期显著改善±dp／dt和CF（P〈O．05），而再灌注末则与Con组相当。SPC组、Fent组及Fent＋SPC组LDH释放量和梗死面积3组之间比较差异均无统计学意义，而较Con组差异有统计学意义（P〈O．05），梗死面积分别为：Con组（45．8±3．2）％，SPC组（22．7±2．3）％，Fent组（20．6±2．8）％，Fent＋SPC组（21．3±3.3）％。结论七氟烷后处理改善离体大鼠I／R心功能，降低心肌梗死面积，芬太尼联合七氟烷后处理抑制左室功能，但不影响心肌梗死面积。Objective To investigate the effects of fentanyl combined with scvoflurane postconditioning on myocardial functions of isolated ischemia-reperfused rat hearts. Methods Depending on the different treatments given at 10 min after reperfusion started, isolated perfused rat hearts were randomly assigned to the following four groups （n=lO）： ischemia/reperfusion （ Con ）, sevoflurane postconditioning （SPC）, fentanyl posteonditioning （Fent）, and fentanyl plus sevoflurane postconditioning （ Fent ＋ SPC）. All of the hearts were subjected to 40 min global myocardial isehemia and 120 min reperfusion. Left ventrieular systolic pressure（LVSP）, Left ventricular developed pressure （LVDP）, maximum increasing rate of LVDP（＋dp/dt）, maximum decreasing rate of LVDP （-alp/tit）, heart rate （HR） and coronary flow （CF） were recorded. Lactate dehydrogenase（LDH） was measured. Infarct size was determined by triphenyhetrazolium chloride staining. Results LVSP, LVDP, ±dp/dt, and CF were higher in SPC group than in Con group at all points of reperfusion （P〈O.05）. Compared with SPC group, the Fent and Fent＋SPC group （P〈0.05） had significantly improved LVSP and LVDP at the beginning 15 rain of reperfusion, which were gradually reduced and lower than SPC group at all time points after 60 rain of reperfusion. There were no significant diffirences in HR among four groups. The values of ±dp/ dt and CFin Fent and Fent＋SPC group were dramatically improved in the early stage of reperfusion（P〈O.05 ）, while similar to the Con group at the end of reperfusion. The SPC, Fent and Fent＋SPC group had a significantly reduced LDH release and decreased infarct size compared with the Con group [（22.7±2.3）%, （20.6±2.8）%, （21.3±3.3）% vs.（45.8±3.2）%, respectively; P〈0.05）. Conclusion Sevoflurane postconditioning improves myocardial

关 键 词：七氟烷 芬太尼 后处理 缺血/再灌注 心功能 

分 类 号：R363[医药卫生—病理学]