芬太尼及甲泼尼龙琥珀酸钠对家兔骨骼肌缺血再灌注损伤的保护机制  

Protective mechanisms of fentanil and methylprednisolone sodium succinate on ischemia-reperfusion injury after rabbit limb replantation

作　　者：丁明[1] 宗波[1] 王学平[2] 

机构地区：[1]解放军89医院麻醉科,山东潍坊261021 [2]潍坊医学院麻醉系,山东潍坊261021

出　　处：《山东大学学报（医学版）》2012年第9期55-58,共4页Journal of Shandong University:Health Sciences

摘　　要：目的观察芬太尼及甲泼尼龙琥珀酸钠对家兔断肢再植肢体缺血再灌注损伤的影响。方法雄性家兔60只,体质量(2.5±0.5)kg。随机分为4组,每组15只,建立右后肢断肢再植模型。对照组(A组)仅作断肢再植,不给予干预措施;芬太尼组(B组)于术中术后给予芬太尼干预;甲泼尼龙琥珀酸钠组(C组)术中术后给予甲泼尼龙琥珀酸钠干预;芬太尼联合甲泼尼龙琥珀酸钠组(D组)同时给予芬太尼、甲泼尼龙琥珀酸钠给予干预。B、C、D 3组于再灌注后4、24、72 h取缺血肢体肌肉组织,观察其Bax和Bcl-2基因表达的变化及24 h肌肉组织超微结构的变化。结果与A组相比,B组4、24 h Bax基因及Bcl-2表达无显著变化(P>0.05),72 h时Bax基因表达降低,Bcl-2表达增高(P<0.05);C、D组各时间点Bax基因表达降低,Bcl-2表达增高(P<0.05);D组与B、C组相比,Bax基因表达降低,Bcl-2表达增高(P<0.05);电镜下,A组和B组线粒体损伤严重,C组和D组线粒体损伤较A、B两组轻。结论芬太尼应用对断肢再植的IRI无保护作用,而甲泼尼龙琥珀酸钠具有保护作用,芬太尼联合甲泼尼龙琥珀酸钠两者有协同作用。Objective To observe the protective effects of fentanil and methylprednisolone sodium succinate on ischemia-reperfusion injury after rabbit limb replantation.Methods 60 adult male rabbits,weighting（2.5±0.5）kg,were randomized devided into four groups（15 rabbits in each group）to establish the replantation models of the right posterior limb.In the control group（group A）,limbs were replanted without treatment.The fentanil group（group B） was given fentanil around replantation and the methylprednisolone sodium succinate group（group C） was given methylprednisolone sodium succinate.In the combining group（group D）,both of the two drugs were given around replantation.Bax and Bcl-2 gene expressions and the ultra microstructure changes of the ischemia limb muscle of group B,C and D were dectected at 4 h,24 h and 72 h after replantation.Results There was no difference between group A and B within 24 h（P0.05）.But at 72 h,the expression of Bax gene was lower and the expression of Bcl-2 was higher（P0.05） in group B.The expression of Bax gene was significantly lower in group C and D,while the expression of Bcl-2 gene was on the contrary.Compared to group B and C,the expression of Bax gene was significantly lower and the expression of Bcl-2 gene was higher in group D（P0.05）.The mitochondrions in group A and B were seriously injured under electron microscope.While the injuries in group C and D were slighter.Conclusion Fentanil has no protective effect on IRI after limb replantation,while methylprednisolone sodium succinate has.Combination of the two drugs shows synergistic efferts on ischemia-reperfusion injury protertion after limb replantation.

关 键 词：芬太尼 甲泼尼龙琥珀酸钠 缺血再灌注损伤 凋亡 

分 类 号：R614.3[医药卫生—麻醉学]