瑞芬太尼对大鼠肾缺血再灌注时细胞凋亡的影响  

Effect of remifentanil on cell apoptosis during renal ischemia/reperfusion in rats

作　　者：金小雪[1] 吕艳霞[1] 孟叶[1] 吕会新 熊颖芬[1] 王力利[3] 

机构地区：[1]河北医科大学第三医院麻醉科,石家庄市050051 [2]石家庄市第一医院营养科 [3]河北医科大学第四医院外科

出　　处：《中华麻醉学杂志》2013年第3期353-356,共4页Chinese Journal of Anesthesiology

基　　金：基金项目：河北省科学技术研究与发展计划项目（10206133D）

摘　　要：目的评价瑞芬太尼对大鼠肾缺血再灌注时细胞凋亡的影响。方法健康成年雄性sD大鼠75只，体重220～250g，采用随机数字表法，将其分为3组（n=25）：假手术组（s组）、肾缺血再灌注组（I／R组）和瑞芬太尼组（R组）。I／R组和R组采用夹闭双侧肾动脉45min时恢复灌注法建立肾缺血再灌注损伤模型。R组于缺血前15min至再灌注30min经尾静脉输注瑞芬太尼1．0μg·kg^-1·min^-1，S组和I／R组给予等容量生理盐水。于缺血前15min（To）、再灌注3h（T1）、6h（T2）、12h（L）及24h（T4）时取肾组织标本。采用流式细胞术检测肾细胞凋亡率及Bax、Bcl-2蛋白表达，采用RT．PCR检测Bax和Bcl-2的mRNA表达，计算Bcl-2／Bax蛋白及mRNA表达比值，采用Paller法行肾小管损伤评分。结果与s组比较，I／R组和R组T1-4时肾小管损伤评分和肾细胞凋亡率升高，Bcl-2／Bax蛋白及mRNA表达比值T1.2时升高，T3,4时降低（P〈0．01）；与I／R组比较，R组L．。时肾小管损伤评分和肾细胞凋亡率降低，Bcl-2／Bax蛋白及mRNA表达比值升高（P〈0．05或0．01）；与Tn时比较，I／R组和R组T1.4时肾小管损伤评分和肾细胞凋亡率升高，Bcl-2／Bax蛋白及mRNA表达比值，T1,2时升高，T3,4时降低（P〈0．01）。结论瑞芬太尼减轻大鼠肾缺血再灌注损伤的机制与其调节Bcl-2／Bax蛋白表达，抑制肾组织细胞凋亡有关。Objective To evaluate the effect of remifentanil on cell apoptosis during renal ischemia-reper- fusion （I/R） in rats. Methods Seventy-five male Sprague-Dawley rats, weighing 220-250 g, were randomly di- vided into 3 groups （ n = 25 each） ： sham operation group （group S）, I/R group, and remifentanil group （group R）. Renal ischemia was induced by occlusion of the bilateral renal arteries for 45 min followed by reperfusion in groups I/R and R. Remifentanil was infused at 1.0 μg·kg^-1·min^-1 via the caudal vein starting from 15 min before ischemia until 30 rain of reperfusion in group Pt, while the equal volume of normal saline was given instead of remifentanil in groups S and I/R. At 15 rain before ischemia （To） and 3, 6, 12, 24 h of reperfusion （T1,4）, 5 rats were anesthetized and sacrificed, and renal specimens were obtained to detect the apoptotic rate and expression of Bax and Bcl-2 protein （by flow cytometry） and mRNA （by RT-PCR）. The ratios between Bcl-2/Bax protein and mRNA expression were calculated. The pathological changes of renal tubules were scored. Results Compared with group S, the pathological scores and apoptotic rate were significantly increased at T1,4 , and ratios between Bcl-2/ Bax protein and mRNA expression were increased at T1,2 , while decreased at T3,4 in groups R and I/R （ P 〈 0. 01 ）. Compared with group I/R, the pathological scores and apoptotic rate were significantly decreased at Tt.4 ,while the ratios between Bcl-2/Bax protein and mRNA expression were increased in group R （ P 〈 0.05 or 0.01 ）. Compared with the baseline value at To, the pathological scores and apoptotic rates were significantly increased at Tl-4 , and the ratios of Bcl-2/Bax protein and mRNA expression were increased at T1,2, while decreased at T3,4 in groups R and I/R （ P 〈 0.01 ）. Conclusion Regulation of Bcl-2/Bax expression and inhibition of cell apoptosis in renal tissues are involved in the mechanism by which remifentanil reduces renal I/R injury in rats.

关 键 词：哌啶类 细胞凋亡 再灌注损伤 肾 

分 类 号：R614[医药卫生—麻醉学]