右美托咪定及其联合舒芬太尼预先给药对大鼠心肌缺血再灌注损伤的影响  

Effect of pretreatment with dexmedetomidine alone or in combination with sufentanil on myocardial isch- emia-reperfusion injury in rats

作　　者：苏玲[1] 屠伟峰[1] 陈茜 郄文斌[1] 欧阳慧碧[1] 

机构地区：[1]广州军区广州总医院麻醉科全军临床麻醉中心,510010 [2]广州市妇女儿童医疗中心麻醉科

出　　处：《中华麻醉学杂志》2013年第5期622-625,共4页Chinese Journal of Anesthesiology

基　　金：广州市科技计划项目（200821-E421）

摘　　要：目的探讨右美托咪定及其联合舒芬太尼预先给药对大鼠心肌缺血再灌注损伤的影响。方法健康清洁级雄性sD大鼠50只，体重250～300g，采用阻断左冠状动脉前降支30min再灌注120min的方法制备心肌缺血再灌注模型。采用随机数字表法，将大鼠分为5组（n=10）：假手术组（S组）只穿线，不结扎左冠状动脉前降支；缺血再灌注损伤组（IR组）；右美托咪定预先给药组（DP组）腹腔注射右美托咪定5μg／kg，30min后制备模型；舒芬太尼预先给药组（SP组）腹腔注射舒芬太尼10／zg／kg，30min后制备模型；右美托咪定＋舒芬太尼预先给药组（Ds组）腹腔注射右美托咪定5／zg／kg和舒芬太尼10tzg／kg，30min后制备模型。再灌注120min时，取血样，测定血清CK、LDH浓度；处死大鼠，观察心肌组织病理学结果，计算心肌梗死体积，测定心肌组织MDA含量及SOD活性。结果与s组相比，其余各组血清CK、LDH浓度升高，心肌梗死体积增加，心肌SOD活性降低，IR组、DP组和sP组心肌MDA含量升高（P〈0．05或0．01），DS组心肌MDA含量差异无统计学意义（P〉0．05）；与IR组相比，DP组、sP组和Ds组血清CK和LDH浓度、心肌MDA含量降低，心肌梗死体积减少，心肌SOD活性升高（P〈0．05）；与DS组相比，DP组和sP组血清CK浓度升高，心肌梗死体积增加，心肌MDA含量升高（P〈0．05），DP组血清LDH浓度升高和心肌SOD活性降低（P〈0．05）。DS组心肌病理学损伤较DP组和sP组减轻。结论右美托咪定预先给药可减轻大鼠心肌缺血再灌注损伤，其联合舒芬太尼预先给药时该效应强于两者单独应用，机制与增强抗氧化能力、抑制脂质过氧化反应有关。Objective To investigate the effect of pretreatment with dexmedetomidine alone or in combi- nation with sufentanil on myocardial ischemia-reperfusion （I/R） injury in rats. Methods Fifty healthy male Spra- gue-Dawley rats, weighing 250-300 g, were anesthetized with intraperitoneal pentobarbital sodium 60 mg/kg. Myo- cardial I/R was induced by occlusion of anterior descending branch of left coronary artery for 30 min followed by 120 rain of reperfusion. The rats were then randomly divided into 5 groups （ n -- 10 each） ： sham operation group （group S）, group I/R, dexmedetomidine pretreatment group （group DP）, sufentanil pretreatment group （group SP）, and dexmedetomidine ＋ sufentanil pretreatment group （group DS）. In group S the anterior descending branch was only exposed but not ligated. Dexmedetomidine 0.5 t^g/kg and sufentanil 0.1 /~g/kg were injected intra- peritoneally 30 min before ischemia in groups DP and SP, respectively. Dexmedetomidine 0.5 ttg/kg and sufentanil 0.1 μg/kg were injected intraperitoneally 30 min before ischemia in group DS. Arterial blood samples were collected at 120 rain of reperfusion for determination of serum creatine kinase （CK） and lactic dehydrogenase （LDH） concentrations. The rats were sacrificed at 120 min of reperfusion and hearts were removed for microscopic exami- nation. Myocardial infarct size was calculated. The malondialdehyde （MDA） content and superoxide dismutase （SOD） activity in myocardial tissues were measured. Results Compared with group S, the serum CK and LDH concentrations were significantly increased, the myocardial infarct size was enlarged, and SOD activity was de- creased in the other groups, MDA content was significantly increased in groups I/R, DP and SP （ P 〈 0.05 or 0.01）. Compared with group I/R, the serum CK and LDH concentrations, MDA content and myocardial infarct size were significantly decreased, and SOD activity was increased in groups DP, SP and DS （P 〈 0.05）. Com- pared with group DS, the serum

关 键 词：右美托咪啶 舒芬太尼 心肌再灌注损伤 

分 类 号：R614[医药卫生—麻醉学]