丙泊酚对离体兔心脏再灌注性心律失常的保护作用及机制研究  

The protective effect of propofol on reperfusioninduced arrhythmias and its mechanisms in isolated rabbit heart

作　　者：朱新运 毛卫克[2] 李保安 何小华 杨吉武 李月庆 

机构地区：[1]解放军第四五八医院,广州市510602 [2]同济医科大学附属协和医院

出　　处：《临床麻醉学杂志》2001年第8期444-446,共3页Journal of Clinical Anesthesiology

摘　　要：目的　在离体兔心脏缺血再灌注模型研究丙泊酚对再灌注性心律失常的保护效应及与氧自由基的关系。方法　 2 4只心脏随机分为缺血再灌 (A)、丙泊酚 10 μmol/L(B)、丙泊酚 2 5 μmol/L(C)和空白对照 (D)四组。A、B和C组心脏行停灌全心缺血 3 0分钟后 ,再灌注 60分钟。结果　缺血前给予丙泊酚 2 5 μmol/L能显著降低复灌时室性心律失常的发生率 (P <0 0 1)和持续时间 ,且使ST段抬高平均值 (MST)和抬高≥ 2mv的点数 (NST)分别减少 62 %和 4 7% (P <0 0 5 )。丙泊酚10 μmol/L并不增强其抗心律失常作用。高浓度丙泊酚显著增强心肌超氧化物歧化酶 (SOD)活力 ,降低缺血后心肌丙二醛 (MDA)及磷酸肌酸 (CK)含量 (P <0 0 5 ) ,但低浓度丙泊酚无上述作用。结论　心肌缺血前给予 2 5 μmol/L丙泊酚能显著减少复灌性心律失常的发生 ,同时减少心肌酶释放 ,其作用可能与其降低心肌氧自由基造成的心肌损伤有关。Objective To investigate the protective effect of propofol on arrhythmias during reperfusion period in the isolated rabbit heart.Methods Twenty four hearts were assigned randomly into normal control,ischemia reperfusion,low dose propofol(10μmol/L) and high dose propofol(25μmol/L) groups.All hearts were subjected to a 30min total heart ischemia followed by 60min reperfusion.Results The incidence of severe ventricular arrhythmias(VF,VT) and its duration were decreased significantly when 25μmol/L propofol was administrated before ischemia,the average level of elevated ST(MST) and the number of ST≥20mv(NST) also decreased by 62% and 47% respectively( P< 0 05).No protective effect on reperfusion induced arrhythmias was observed in low dose propofol group.The activity of SOD increased and content of MDA,CK in heart tissue declined significantly in 25μmol/L propofol group.Conclusion 25μmol/L propofol given before ischemia has a protective effect on reperfusion induced ventricular arrhythmias.The mechanism involves its attenuating oxygen free radical mediated injury of the myocardium.

关 键 词：丙泊酚 心肌缺血 再灌注损伤 心律失常 氧自由基 兔 心脏 保护作用 

分 类 号：R614[医药卫生—麻醉学]