瑞芬太尼在皮瓣缺血再灌注损伤中的作用及机制  

The function and mechanism of remifentanil in flap ischemia-reperfusion injury

作　　者：黄磊[1] 邱汉红[1] 武连生[1] 

机构地区：[1]武汉大学中南医院整形外科,430071

出　　处：《中华实验外科杂志》2014年第8期1697-1699,共3页Chinese Journal of Experimental Surgery

摘　　要：目的 探讨瑞芬太尼在皮瓣缺血再灌注损伤中的作用及机制.方法 将80只雄性SD大鼠随机分为：假手术组（20只）、缺血再灌注（I/R）组（20只）、瑞芬太尼组（20只）、Toll样受体4（TLR4）抑制剂组（20只）.制备皮瓣I/R模型.瑞芬太尼组和TLR4抑制剂组于再灌注前静脉注射瑞芬太尼1 μg/（kg· min）和E5564（5 mg/kg）,分别于缺血再灌注后2、4、8h,采用实时定量聚合酶链反应（Real-time PCR）和Western blot检测TLR4和核因子-κB （NF-κB）在皮瓣组织中的表达.于术后7d,应用图像分析软件计算皮瓣存活比例.结果 Real-time PCR和Western blot检测显示I/R组比瑞芬太尼组和TLR4抑制组TLR4及NF-κB表达明显增强.瑞芬太尼组和TLR4抑制组再灌注后TLR4和NF-κB活性受到抑制.术后7dI/R组、瑞芬太尼组和TLR4抑制剂组皮瓣存活比例分别为（61.40±7.12）％、（80.31±11.63）％和（82.10±10.21）％,与I/R组比较差异有统计学意义（P＜0.05）.结论 瑞芬太尼可以通过抑制TLR4表达及减少NF-κB活化,减轻皮瓣缺血再灌注损伤.Objective To investigate the function and mechanism of remifentanil in flap ischemiareperfusion injury （IRI）.Methods A totol of 80 adult male SD rats were randomly divided into 4 groups：sham-operated group （n =20）,IRI group （n =20）,remifentanil group （n =20） and Toll-like receptor 4 （TLR4） inhibitor group （n＝20）.Flap IRI model was established.Remifentanil group and TLR4 inhibitor group before reperfusion were intravenously injected with remifentanil 1 μg/（kg· min） and E5564 （5 mg/kg）,respectively.At 2,4 and 8 h after I/R,real-time quantitative polymerase chain reaction （Real-time PCR） and Western blotting were applied to detect the expression of TLR4 and nuclear factor-κB （NF-κB） in the flap tissue.On the postoperative day 7,image analysis software was used to calculate flap survival rate.Results The Real-time PCR and Western blotting showed that the expression of TLR4 and NF-κB was significantly enhanced in IRI group as compared with remifentanil group and TLR4 inhibitor group.The expression of TLR4 and NF-κB was inhibited after reperfusion in remifentanil group and TLR4 inhibitor group.On the postoperative day 7,the flap survival rate in IRI group,remifentanil group and TLR4 inhibitor group was （61.40 ±7.12）％,（80.31 ± 11.63）％ and （82.10 ± 10.21）％ respectively,and there was significant difference between IRI group and remifentanil group or TLR4 inhibitor group （P ＜ 0.05 for both）.Conclusion Remifentanil may alleviate flap IRI by inhibiting TLR4 expression and activation of NF-κB.

关 键 词：瑞芬太尼 皮瓣缺血 再灌注损伤 TOLL样受体4 核因子-ΚB 

分 类 号：R622[医药卫生—整形外科]