瑞芬太尼预先给药对大鼠肢体缺血再灌注致肾损伤的影响  

Effects of remifentanil preconditioning on renal injury induced by limb ischemia-reperfusion in rats

作　　者：杨禄坤[1] 白雪玲[2] 肖笑雨[1] 张荣凯[3] 

机构地区：[1]中山大学附属第五医院麻醉科,珠海市519000 [2]中山大学附属第五医院手术室,珠海市519000 [3]中山大学附属第五医院骨外科,珠海市519000

出　　处：《中华麻醉学杂志》2014年第9期1048-1050,共3页Chinese Journal of Anesthesiology

基　　金：珠海市科技计划项目（2013D0401990003）

摘　　要：目的 评价瑞芬太尼预先给药对大鼠肢体缺血再灌注致肾损伤的影响.方法 健康雄性SD大鼠27只,体重200 ～ 250 g,按照随机数字表法分为3组（n=9）：假手术组（Sham组）、肢体缺血再灌注致肾损伤组（I/R组）和瑞芬太尼预先给药组（RPC组）.I/R组和RPC组采用无创微动脉夹夹闭大鼠双侧股动静脉2h,再灌注24h的方法制备肢体缺血再灌注模型,Sham组仅暴露股动静脉,不阻断.RPC组缺血前尾静脉输注瑞芬太尼1.0 μg·kg-1·min-持续30 min,Sham组和I/R组输注等容量生理盐水.于再灌注24 h时抽取下腔静脉血样,断头处死大鼠取左肾.采用自动生化分析仪测定血清尿素氮（BUN）和肌酐（Cr）的浓度,ELISA法测定肾组织肿瘤坏死因子-α（TNF-α）和白细胞介素6（IL-6）的含量,TUNEL法检测肾组织细胞凋亡情况,计算凋亡指数（AI）,HE染色光镜下观察肾组织病理学形态.结果 与Sham组比较,I/R组和RPC组血清BUN和Cr浓度、肾组织TNF-α和IL-6含量及AI均升高（P＜0.05）,肾组织病理学损伤明显;与I/R组比较,RPC组血清BUN和Cr浓度、肾组织TNF-α和IL-6含量及AI均降低（P＜0.05）,肾组织病理学损伤减轻.结论 瑞芬太尼预先给药可减轻肢体缺血再灌注致大鼠肾损伤,其机制可能与抑制肾组织炎症反应和细胞凋亡有关.Objective To evaluate the effects of remifentanil preconditioning on the renal injury induced by limb ischemia-repeffusion （I/R） in rats. Methods Twenty-seven healthy male Sprague-Dawley rats, weighing 200-250 g, were randomly assigned into 3 groups （ n = 9 each） ： sham operation group （Sham group） , I/R group and remifentanil preconditioning group （RPC group） . Limb isehemia was induced by clamping bilateral femoral arteries and veins for 2 h, followed by 24 h reperfusion in I/R and RPC groups. Remifentanil 1.0 ~g＂ kg-l . min-l was infused via the caudal vein for 30 min before isehemia in RPC group, while the equal volume of normal saline was given in Sham and I/R groups. Blood sample was taken from the inferior vena cava at 24 h of reperfusion to measure blood urea nitrogen （BUN） and creatinine （Cr） concentrations in serum. The rats were sacrificed and the left kidney was removed for determination of tumor necrosis factor-alpha （TNF-α） and interleukin-6 （IL-6） contents, cell apoptosis and microscopic examination of pathological changes. Apoptosis index was calculated. Results Apoptosis index and concentrations of BUN and Cr in serum, TNF-α and IL-6 contents, and apoptosis index were significantly higher, and the pathological changes were more severe in I/R and RPC groups than in Sham group. Compared with group I/R, concentrations of BUN and Cr in serum, TNF-α and IL-6 contents, and apoptosis index were significantly decreased, and the pathological changes were attenuated in RPC group. Conclusion Remifentanil preconditioning can attenuate renal injury induced by limb I/R in rats, and inhibition of inflammatory responses and cell apoptosis in kidney may be involved in the mechanism.

关 键 词：哌啶类 再灌注损伤 四肢 肾 

分 类 号：R614[医药卫生—麻醉学]