瑞芬太尼预处理对老龄大鼠心肌缺血再灌注损伤的影响  

Effect of remifentanil preconditioning on myocardial ischemia-reperfusion injury in aged rats

作　　者：龙文飞[1] 钟敏[1] 肖建斌[1] 杨凯[1] 

机构地区：[1]广东省中医院麻醉科,广州市510120

出　　处：《中华麻醉学杂志》2015年第3期358-360,共3页Chinese Journal of Anesthesiology

基　　金：基金项目：广东省科技计划项目（20118031800027）

摘　　要：目的评价瑞芬太尼预处理对老龄大鼠心肌缺血再灌注损伤的影响。方法雄性SD大鼠24只，15～18月龄，体重465～580g，采用随机数字表法分为3组（n=8）：假手术组（S组）、缺血再灌注组（I／R组）和瑞芬太尼预处理组（RP组）。I／R组采用结扎左冠状动脉前降支30min，再灌注120min的方法制备心肌缺血再灌注损伤模型；RP组静脉输注瑞芬太尼10μg·kg^-1·min～20min，洗脱10min，然后制备心肌缺血再灌注损伤模型；S组只穿线，不结扎左冠状动脉前降支。分别于缺血前30min和再灌注120min时，测定血清乳酸脱氢酶（LDH）和肌酸激酶同工酶（CK—MB）的活性。再灌注120min时，取心肌组织测定心肌梗死体积，计算心肌梗死体积百分比，并观察超微结构。结果与S组比较，I／R组和RP组再灌注120min时血清LDH和CK—MB的活性升高（P〈0．05）；与I／R组比较，RP组再灌注120min时血清LDH和CK-MB的活性降低，心肌梗死体积百分比减小（P〈0．05），病理学损伤减轻。结论瑞芬太尼预处理可减轻老龄大鼠心肌缺血再灌注损伤。Objective To evaluate the effect a-reperfusion （I/R） injury in aged rats. Methods of remifentanil preconditioning on myocardial ischemi- Twenty-four healthy male Sprague-Dawley rats, aged 15-18 months, weighing 465-580 g, were randomly divided into 3 groups （n = 8 each） using a random number table： sham operation group （group S） , group I/R and remifentanil preconditioning group （group RP）. The animals were anesthetized with intraperitoneal 10% chloral hydrate 300 mg/kg. Myocardial I/R was induced by 30 min occlusion of anterior descending branch of left coronary artery followed by 120 min reperfusion in group I/R. In group RP, remifentanil 10 p,g ~ kg ~ ~ min-1 was infused intravenously for 20 min followed by 10 min washout before myocardial I/R. In group S, the anterior descending branch was on- ly exposed but not ligated. At 30 min before ligation and 120 min of reperfusion, the activities of serum lac- tate dehydrogenase （LDH） and creatine kinase-MB （CK-MB） were determined. The hearts were removed at 120 rain of reperfusion for determination of myocardial infarct size, the percentage of myocardial infarct size was calculated, and myocardial specimens were obtained for observing myocardial ultrastructure. Re- sults Compared with group S, the activities of serum LDH and CK-MB were significantly increased at 120 min of reperfusion in I/R and RP groups. Compared with group I/R, the activities of serum LDH and CK- MB were significantly decreased, the percentage of myocardial infarct size was decreased, and the patho- logical changes were attenuated in group RP. Conclusion Remifentanil preconditioning can attenuate my- ocardial I/R injury in aged rats.

关 键 词：哌啶类 缺血预处理 心肌再灌注损伤 老年人 

分 类 号：R614[医药卫生—麻醉学]