瑞芬太尼对垂体后叶素兔致心肌损伤肌酸激酶同工酶的影响  

Effect of remifentanil pretreatment on creatine kinase isoenzyme after acute myocardial injury induced by pituitrin in rabbits

作　　者：曹译匀[1] 汤翠翠[1] 苏晓乾[2] 杨波 孟尽海[1] 

机构地区：[1]宁夏医科大学总院麻醉科,银川市750004 [2]宁夏医科大学总院药剂科,银川市750004 [3]银川市妇幼保健院妇科

出　　处：《临床麻醉学杂志》2012年第11期1105-1108,共4页Journal of Clinical Anesthesiology

摘　　要：目的探讨瑞芬太尼对兔垂体后叶素心肌损伤的药物预处理作用。方法健康中国白兔40只,雌雄不限,体重1.5～2.5kg,随机均分为五组:A组静注生理盐水0.3ml/kg;B组静注垂体后叶素2.5U/kg;C组静注吗啡3.3mg/kg,30min后静注2.5U/kg垂体后叶素;D组持续静脉泵注瑞芬太尼3.3μg.kg-1.min-130min;E组持续静脉泵注瑞芬太尼3.3μg.kg-1.min-130min后静注2.5U/kg垂体后叶素;各组容量为0.3ml/kg。观察记录给予垂体后叶素前即刻(T0,缺血前,A、D组为给药前)、给予垂体后叶素后(缺血后,A、D组为给药后)1min(T1)、2min(T2)、3min(T3)、5min(T4)、10min(T5)、20min(T6)MAP,记录T0、缺血后24h(T7)、48h(T8)瑞芬太尼对心肌梗死兔血清肌酸激酶同工酶(CK-MB)含量及心肌病理形态学变化的影响。结果与T0时比较,T2、T3时B组MAP明显升高,T5、T6时B、D和E组MAP明显降低(P<0.05)。与A组比较,T2、T3时B、E组MAP明显升高(P<0.01或P<0.05)。与B组比较,T1、T2时D组MAP明显降低(P<0.01)。与E组比较,T2、T3时C、D组MAP明显降低(P<0.01或P<0.05)。T7、T8时B、C和E组血清CK-MB含量明显高于T0时和A组(P<0.01)。T7、T8时C、D和E组血清CK-MB含量明显低于B组,且D组血清CK-MB含量明显低于E组(P<0.01)。结论瑞芬太尼预处理可影响兔垂体后叶素造成的血流动力学的变化,并降低兔缺血-再灌注心肌损伤模型血清CK-MB的含量。Objective To investigate whether remifentanil can protect the heart against myocardial ischemia-reperfusion injury. Methods Fourty healthy white adult Chinese rabbits were divided into five groups： Group A, 0. 3 ml/kg of saline iv. ; Group B, 2. 5 U/kg of pituitrin iv. ; Group C, 3.3 mg/kg of morphine and 2.5 U/kg of pituitrin iv. ; Group D, continuous pumping of 3.3 μg·kg^-1·min^-1 30 min; and Group E, continuous pumping of 3.3 μg·kg^-1·min^-1 30 min and 2.5 U/kg of pituitrin iv. ; the total volume was 3.3 ml/kg. Records injection of pituitrin immediately before （To, before ischemia, groups A, D for pre-dose）, 1min （T1）,2 rain （T2）, 3 min （T3）, 5 min （T4）, 10 rain （T5）, 20 rain （T6） after pituitrin （afterischemic, A, D group for administration） of MAP; at To, ischemie 24 h （T7）, 48 h （T8） remifentanil rabbit myocardial infarctionserum creatine kinase isoenzyme （CK-MB） content were recorded; and myocardial pathomorphological changes. Results Compared with To, MAP was significantly higher in group B at T2, T3, and MAP decreased significantly in groups B, D and E at TO and T6 （P〈0. 05）. Compared with group A, MAP was significantly higher at T2 and T3 in groups B and E （P〈0. 01 or P〈0. 05）. Compared with group B, MAP decreased significantly at T1, T2 in group D（P〈0. 01）. Compared with group E, MAP was significantly decreased at T2, T3 in groups C, D, （P〈0.01 or P〈0.05）. At T7, T5, groups B, C and E CK-MB content were significantly higher than that at To and group A （P〈0. 01）. At T7, T8 groups C, D and E CK-MB content lower in group B, and in group D CK-MB content were significantly lower than group E （P〈0. 01）. Conclusion Remifentanil not only can defend the heart from pituitrin harm but also can decrease the level of CK-MB in injured cardiac tissue.

关 键 词：心肌缺血-再灌注损伤 预处理 瑞芬太尼 吗啡 肌酸激酶同工酶 

分 类 号：R614[医药卫生—麻醉学]