阿片受体在瑞芬太尼减轻大鼠肾脏缺血再灌注损伤中的作用  

Role of opioid receptors in remifentanil-induced attenuation of renal ischemia/reperfusion injury in rats

作　　者：熊颖芬[1] 金小雪[1] 孟叶[1] 吕艳霞[1] 王秀丽[1] 

机构地区：[1]河北医科大学第三医院麻醉科,石家庄市050051

出　　处：《中华麻醉学杂志》2012年第7期877-879,共3页Chinese Journal of Anesthesiology

基　　金：河北省科学技术研究与发展计划项目（10206133D）

摘　　要：目的探讨阿片受体在瑞芬太尼减轻肾脏缺血再灌注损伤中的作用。方法雄性sD大鼠75只，体重250～300g，采用随机数字表法，将其随机分为5组（n=15）：假手术组（S组）、肾脏缺血再灌注损伤组（I／R组）、瑞芬太尼组（R组）、纳洛酮组（N组）、纳洛酮＋瑞芬太尼组（NR组）。采用夹闭双侧肾动脉45min再恢复灌注的方法制备大鼠肾脏缺血再灌注损伤模型。R组和NR组于缺血前15min至再灌注30min尾静脉输注瑞芬太尼1．0μg·kg-1·min-1，s组、I／R组和N组输注等容量生理盐水；N组和NR组于缺血前20min及间隔55min分别尾静脉注射纳洛酮0．3mg／kg，S组、I／R组和R组注射等容量生理盐水。再灌注24h时采集股静脉血样和抽取膀胱尿样，用于测定血清Cr和BUN浓度及尿N-乙酰-β—D-氨基葡萄糖苷酶（NAG）和γ-谷氨酰转肽酶（γ-GT）水平。随后取肾组织，采用黄嘌呤氧化法和硫代巴比妥酸法分别测定SOD活性及MDA含量，并于光镜下观察肾脏病理学结果。结果与S组比较，其他4组血清Cr和BUN浓度、尿NAG和γ-GT水平及肾组织MDA含量升高，SOD活性降低（P〈0．05或0．01），其肾组织有不同程度病理学损伤。与I／R组比较，R组血清Cr和BUN浓度、尿NAG和γ-GT水平及肾组织MDA含量降低，SOD活性升高（P〈0．01），其肾组织病理学改变明显减轻；而N组和NR组以上各指标的差异无统计学意义（P〉0．05），肾组织病理学改变相似；与R组比较，N组和NR组血清Cr和BUN浓度、尿NAG和γ-GT水平及肾组织MDA含量升高，SOD活性降低（P〈0．05或0．01）。结论阿片受体介导了瑞芬太尼减轻大鼠。肾脏缺血再灌注损伤的作用。Objective To investigate the role of opioid receptors in remifentanil-induced attenuation of renal ischemia/reperfusion （I/R） injury in rats. Methods Seventy-five male Sprague-Dawley rats weighing 250-300 g were randomly divided into 5 groups （ n = 15 each） ： sham operation group （group S）, group I/R, remifentanil group （group R）, naloxone group （group N）, and naloxone ＋ remifentanil group （group NR）. Renal ischemia was induced by clamping the bilateral renal arteries for 45 min using an atraumatic clamp followed by reperfusion. In groups R and NR, remifentanil was infused at 1.0μg·kg-1·min-1 via the caudal vein starting from 15 min before ischemia until 30 min of reperfusion, while groups S, I/R and N received the equal volume of normal saline instead of remifentanil. In groups N and NR, naloxone 0.3 mg/kg was injected via the caudal vein at 20 min before ischemia and at 35 min after ischemia respectively, while groups S, I/R and R received the equal volume of normal saline instead of naloxone. Blood and urine samples were collected from the femoral vein and urinary bladder respectively at 24 h of reperfusion for determination of the levels of serum creatinine （Cr） and blood urea nitrogen （BUN）, urinary N-acetyl-β-D-glucosaminidase （NAG） and γ-glutamyl transpeptidase （γ-GT）. The rats were sacrificed at 24 h of reperfusion and the renal tissues were removed for determination of malondialdehyde （MDA） content and superoxide dismutase （SOD） activity. Pathological changes in renal tissues were observed with light microscope. Results Compared with＇group S, the levels of serum Cr and BUN, urinary NAG and γ-GT, and MDA were significantly increased, while the activity of SOD was significantly dtcreased in the other 4 groups （ P 〈 0.05 or 0.01 ） and pathological changes in renal tissues were observed in the other 4 groups. Compared With group （ I/R, the levels of serum Cr and BUN, urinary NAG and γ-GT levels, and MDA were significantly decreased, while

关 键 词：受体 阿片样 哌啶类 肾 再灌注损伤 

分 类 号：R614[医药卫生—麻醉学] R-332[医药卫生—外科学]