瑞芬太尼对兔离体心脏窦房结功能及心肌β1肾上腺素能受体表达的影响  

Effects of remifentanil on the function of sinus node and the expression of cardiac β1-adrenoreceptors in isolated rabbit heart

作　　者：史静[1] 方开云[2] 何祥[2] 马国才[1] 高鸿[1] 安裕文[1] 

机构地区：[1]贵阳医学院附属医院麻醉科,贵阳市550004 [2]贵州省人民医院麻醉科

出　　处：《临床麻醉学杂志》2012年第5期504-506,共3页Journal of Clinical Anesthesiology

摘　　要：目的观察瑞芬太尼对兔离体心脏窦房结功能及心肌β1肾上腺素能受体表达的影响。方法健康家兔24只,体重2.0～2.5kg,随机均分为三组:对照组(C组)、瑞芬太尼4、12ng/ml组(R1、R2组)。心脏取出后,连接于Langendoff离体灌注装置,并用K-H液(95%O2+5%CO2)进行恒温恒压逆行灌注。C组持续灌注正常K-H液40min;R1组、R2组灌注K-H液15min后,分别灌注含瑞芬太尼4、12ng/ml的K-H液25min。于灌注瑞芬太尼(正常K-H液,C组相应时点)前(T0)、灌注25min(T1)时记录HR、窦房传导时间(SACT)、窦房结功能恢复时间(SNRT)、校正SNRT(CS-NRT)。随后取右心房心肌组织,检测心肌β1肾上腺素能受体的表达水平。结果与T0时比较,T1时R1、R2组HR减慢(P<0.05),R2组SACT、SNRT和CSNRT明显延长(P<0.05),C组差异无统计学意义。R1和R2组心肌β1肾上腺素能受体表达均较C组明显降低(P<0.05),但R1和R2组间差异无统计学意义。结论瑞芬太尼可通过抑制窦房结功能和下调心肌β1肾上腺素能受体的表达减慢HR。Objective To investigate the effects of remifentanil on the function of sinus node and the expression of cardiac β1-adrenoreceptors in isolated rabbit heart. Methods Twenty-four rabbits weighing 2-2.5 kg were equally randomized into 3 groups： control group （group C）, remifentanil 4 or 12 ng/ml group （group R1 or group Ra ）. The removed hearts were connected to the Langendoff technique and the retrograde perfusion with Kreb-Hensleit （K-H） buffer solution （95%O2＋5% CO2 ） was performed under the constant temperature and pressure. The isolated hearts were constantly perfused with normal K-H buffer solution for 40 min in group C; while the isolated hearts were perfused with K-H buffer solution for 15 min and then with K-H buffer solution containing remifentanil 4 or 12 ng/ml for 25 min in group R1 or R2, respectively. HR, sinoatrial conduction time （SACT）, sinus node recovery time （SNRT）, and corrected sinus node recovery time （CSNRT） were recorded before （T0） and 25 min after the remifentanil perfusion （T1）. Subsequently, the right atrial myocardium was removed to determine the expression of β1-adrenoreceptors. Results Compared with To, there was a significant decrease of HR in group R1 and group R2 （P〈0. 05）and a significant prolongation of SACT, SNRT and CSNRT in group R2 （P〈0. 05） at Tt ; however, no significant difference in group C was detected. The expression of β1-adrenoreceptors was lower in group R1 and group R2 than that in group C （P〈0. 05）, there was no significant difference between Rt and R2 groups. Conclusion Remifentanil may reduce HR by depressing the function of sinus node and decreasing the expression of β1-adrenoreceptors in myocardiun.

关 键 词：瑞芬太尼 窦房结 心肌 Β1肾上腺素能受体 

分 类 号：R965[医药卫生—药理学]