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作 者:谢明明[1] 吕艳霞[1] 孟叶[1] 袁天宝[1] 金小雪[1]
机构地区:[1]河北医科大学第三医院麻醉科,石家庄市050051
出 处:《中华麻醉学杂志》2015年第6期758-761,共4页Chinese Journal of Anesthesiology
基 金:河北省科学技术研究与发展计划项目(10206133D)
摘 要:目的 探讨瑞芬太尼对大鼠肾缺血再灌注时Toll样受体2(TLR2) mRNA表达的影响.方法 健康成年雄性SD大鼠54只,体重200~ 250 g,采用随机数字表法分为3组(n=18):假手术组(S组)、肾缺血再灌注组(Ⅰ/R组)和瑞芬太尼组(R组).Ⅰ/R组和R组采用夹闭双侧肾动脉45min恢复再灌注的方法制备大鼠肾缺血再灌注损伤模型.R组于缺血前15 min至再灌注30 min经尾静脉输注瑞芬太尼1.0 μg· kg-1·min-1,S组和Ⅰ/R组输注等容量生理盐水.于缺血前15 min、再灌注6和24 h时取肾组织,光镜下观察肾组织病理学结果,采用ELISA法检测肾组织TNF-α和IL-6的含量,流式细胞术双染法测定细胞凋亡率,RT-PCR法检测TLR2 mRNA的表达水平.结果 与S组比较,Ⅰ/R组和R组再灌注6和24 h时肾组织TLR2 mRNA表达上调,TNF-α和IL-6含量及细胞凋亡率升高(P<0.01);与Ⅰ/R组比较,R组再灌注6和24 h时肾组织TLR2 mRNA表达下调,TNF-α和IL-6含量及细胞凋亡率降低(P<0.05或0.01).R组肾组织病理学损伤较Ⅰ/R组减轻.结论 瑞芬太尼减轻大鼠肾缺血再灌注损伤的机制与其下调TLR2表达,降低其活性,进而抑制肾组织炎性反应和细胞凋亡有关.Objective To evaluate the effect of remifentanil on Toll-like receptor 2 (TLR2) mRNA expression during renal ischemia-reperfusion (Ⅰ/R) in rats.Methods Fifty-four male Sprague-Dawley rats,weighing 200-250 g,were randomly divided into 3 groups (n=18 each) using a random number table:sham operation group (group S),Ⅰ/R group and remifentanil group (group R).Renal Ⅰ/R injury was produced by clamping the bilateral renal arteries for 45 min followed by reperfusion in Ⅰ/R and R groups.Bilateral renal arteries were only exposed but not clamped in group S.Remifentanil 1.0 μg · kg-1 · min-1 was infused via the tail vein starting from 15 min before ischemia until 30 min of reperfusion in group R,while the equal volume of normal saline was given instead in S and Ⅰ/R groups.The animals were sacrificed at 15 min before ischemia and 6 and 24 h of reperfusion,and the renal specimens were obtained for examination of the pathological changes (with light microscope) and for determination of the contents of tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) (by ELISA) and expression of TLR2 mRNA (by RT-PCR) and cell apoptosis (by double staining and flow eytometry).The apoptotic rate was calculated.Results Compared with group S,TLR2 mRNA expression was significantly up-regulated,and the contents of TNF-α and IL-6 and apoptotic rate were increased at 6 and 24 h of reperfusion in Ⅰ/R and R groups.Compared with group Ⅰ/R,TLR2 mRNA expression was significantly down-regulated,and the contents of TNF-α and IL-6 and apoptotic rate were decreased at 6 and 24 h of reperfusion in group R.The pathological changes were significantly attenuated in group R as compared with group Ⅰ/R.Conclusion The mechanism by which remifentanil reduces renal Ⅰ/R injury is related to down-regulation of TLR2 expression and decrease in TLR2 activity and inhibition of inflammatory responses in renal tissues and cell apoptosis in rats.
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