瑞芬太尼对肝硬化大鼠肝脏缺血再灌注损伤的影响  

Effect of remifentanil on hepatic ischemia-reperfusion injury in rats with liver cirrhosis

作　　者：井蕊[1] 马万[1] 马刚[1] 王建珍[1] 刘玉华[2] 

机构地区：[1]宁夏医科大学附属医院麻醉科,银川市750004 [2]河北省医学情报研究所《中华麻醉学杂志》编辑部

出　　处：《中华麻醉学杂志》2011年第7期865-867,共3页Chinese Journal of Anesthesiology

基　　金：宁夏回族自治区自然科学基金（NZ10156）

摘　　要：目的探讨瑞芬太尼对肝硬化大鼠肝脏缺血再灌注损伤的影响。方法成年健康雄性SD大鼠30只，体重260—300g，采用随机数字表法，将其随机分为3组（n=10）：肝硬化组（C组）、肝硬化＋肝缺血再灌注组（I／R组）和瑞芬太尼组（R组）。C组、I／R组和R组采用四因素综合法制备大鼠肝硬化模型，I／R组和R组在肝硬化模型制备成功后1周制备大鼠70％肝脏缺血再灌注模型，R组于缺血前10min开始静脉输注瑞芬太尼1μg·kg^-1·min。至再灌注结束。于再灌注4h时取静脉血样和肝组织，测定血清ALT和AST活性、肝细胞Bcl-2和Bax表达及肝细胞凋亡情况，计算细胞凋亡指数，光镜下观察肝组织病理学结果。结果与c组比较，I／R组血清ALT和AST的活性升高，肝细胞Bcl-2表达下调，Bax表达上调，细胞凋亡指数升高（P〈0．05）；与I／R组比较，R组血清ALT和AST的活性降低，肝细胞Bcl-2表达上调，Bax表达下调，细胞凋亡指数降低（P〈0．05）。R组肝组织病理学损伤轻于I／R组。结论瑞芬太尼可减轻肝硬化大鼠肝脏缺血再灌注损伤，其机制与平衡肝细胞Bcl-2与Bax表达而抑制肝细胞凋亡有关。Objective To investigate the effect of remifentanil on hepatic ischemia-reperfusion （I/R） injury in rats with liver cirrhosis. Methods Thirty male SD rats weighing 260-300 g were randomly divided into 3 groups （n = 10 each）： group liver cirrhosis （group C）; group liver cirrhosis ＋ hepatic 1/R （group I/R） and group remifentanil （group R）. Liver cirrhosis was produced in all animals in the 3 goups. I/R injury was induced by 20 min occlusion of the hepatic artery and portal vein entering the middle and left lobes of the liver followed by 4 h reperfusion at 1 week after establishment of hepatic cirrhosis in I/R and R groups. In group R remifentanil was infused iv at 1 μg kg-1. min-1 starting from 10 min before ischemia until the end of 4 h reperfusion. Venous blood samples were taken from inferior vena cava at the end of 4 h reperfusion for measurement of serum ALT and AST activities. The animals were then sacrificed and liver specimens were taken from middle lobe for determination of Bcl-2 and Bax expression （by immuno-histoehemistry） and hepatocyte apoptosis （by TUNEL） and microscopic examination. Apoptosis index （percentage of apoptotic cells） was calculated. Results I/R significantly increased serum ALT and AST activities, Bax expression and apoptosis index and decreased Bcl-2 expression in group I/R as compared with group C. Remifentanil significantly attenuated the l/R-induced changes in serum ALT and AST activities, Bax and Bcl-2 expression and apoptosis in group R as compared with group I/R. Remifentanil also amelio- rated 1/R-induced liver damage. Conclusion Remifentanil can attenuate hepatic I/R injury in rats with liver cirrhosis by up-regulating Bcl-2 expression and down-regulating Bax expression and inhibiting apoptosis.

关 键 词：哌啶类 再灌注损伤 肝 肝硬化 实验性 

分 类 号：R965[医药卫生—药理学]