糖尿病因素对舒芬太尼后处理减轻大鼠心肌缺血再灌注损伤的影响  

Effect of diabetes mellitus factor on attenuation of myocardial ischemia-reperfusion injury by sufentanil postconditioning in rats

作　　者：陈巧玲[1] 顾尔伟[1] 方卫平[1] 曹袁媛[1] 张雷[1] 朱燕[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》2011年第9期1129-1132,共4页Chinese Journal of Anesthesiology

基　　金：安徽省教育厅省级重点科研项目（KJ2010A180）

摘　　要：目的探讨糖尿病因素对舒芬太尼后处理减轻大鼠心肌缺血再灌注损伤的影响。方法健康成年雄性sD大鼠，体重250。300g，采用腹腔注射链脲佐菌素50mg／kg的方法制备糖尿病模型。取造模成功的大鼠30只，采用随机数字表法，将其随机分为3组（n=10）：糖尿病假手术组（DM—S组）、糖尿病缺血再灌注组（DM—IR组）和糖尿病舒芬太尼后处理组（DM．SP组）。另取正常大鼠30只，采用随机数字表法，将其随机分为3组（n=10）：非糖尿病假手术组（NDM—S组）、非糖尿病缺血再灌注组（NDM-IR组）和非糖尿病舒芬太尼后处理组（NDM—SP组）。采用结扎左冠状动脉前降支30min后再灌注的方法制备心肌缺血再灌注模型。SP组于再灌注前5min经颈静脉注射舒芬太尼1．0μg／kg。于缺血前、缺血30min和再灌注120min时记录MAP、SBP和HR，计算收缩压心率乘积（RPP）。再灌注120min时取血样，测定血浆cTnI浓度，处死大鼠后，取心脏，测定左右心室体积之和、缺血危险区体积（AAR）和梗死区体积（1s），计算IS／AAR。结果非糖尿病和糖尿病大鼠心肌缺血再灌注时MAP、RPP降低，血浆cTnI浓度升高，心肌发生梗死样改变。舒芬太尼后处理可降低非糖尿病大鼠心肌缺血再灌注时IS、IS／ARR和血浆cTnI浓度，对糖尿病大鼠心肌缺血再灌注时各指标无明显影响。DM．SP组IS、IS／ARR和血浆cTnI浓度明显高于NDM—SP组（P〈0．05）。结论糖尿病因素可消除舒芬太尼后处理减轻大鼠心肌缺血再灌注损伤的作用。Objective To investigate effect of diabetes mellitus factor on attenuation of myocardial ischemia-reperfusion injury by sufentanil postconditioning in rats. Methods Diabetes mellitus was established by intraperitoneal streptozotocin 50 mg/kg and was confirmed by blood glucose ≥ 16.7 mmol/L. Thirty healthy adult male SD rats, weighing 250-300 g which diabetes mellitus model was successfully established were randomly divided into 3 groups （n = 10 each） ：diabetic mellitus sham operation group （group DM-S）, diabetic mellitus ischemia-reperfusion group （group DM-IR） and diabetic mellitus sufentanil postconditioning group （group DM-SP）. Another 30 nondiabetic mellitus rats were also randomly divided into 3 group （ n = 10 each） ： nondiabetic mellitus sham operation group （group NDM-S）, nondiabetic meIIitus ischemia-reperfusion group （group NDM-IR） and nondiabetic mellitus sufentanil postconditioning group （group NDM-SP）. Myocardial ischemia-reperfusion was induced by 30 min occlusion of left anterior descending branch of coronary artery followed by reperfusion. Sufentanil postcondi- tioning was induced by iv injection of sufentanil 1.0μg/kg at 5 min before reperfusion. MAP, SBP, HR and RPP （HR × SBP） were recorded before ischemia, 30 min of ischemia and 120 min of reperfusion. Arterial blood sampies were collected at 120 rain of reperfusion for measurement of plasma cardiac troponin I （cTnI） concentration. The animals were then sacrificed for determination of total areas of right and left ventricles （ LV ＋ RV）, infarct area （IS）, area at risk （AAR） and IS/AAR.Results MAP and RPP were significantly lower, while plasma cTnI concentration was higher during myocardial ischemia reperfusion in diabetic and nondiabetic rats. Sufentanil postconditioning significantly decreased IS, IS/AAR and plasma cTnI concentration in nondiabetic rats during myocardial ischemia reperfusion but had no effect on IS, IS/AAR and plasma cTnI concentration in diabetic rats. The IS, IS/ A

关 键 词：糖尿病 舒芬太尼 心肌再灌注损伤 后处理 

分 类 号：R614[医药卫生—麻醉学]