七氟醚对心脏骤停大鼠心肌保护作用的研究  

The effects of sevoflurane on myocardial damage after cardiopulmonary resuscitation in rats

作　　者：李恒杰[1] 魏红艳[1] 邓宇斌[2] 李芳[1] 卢远征[1] 胡春林[1] 李欣[1] 廖晓星[1] 

机构地区：[1]中山大学附属第一医院急诊科,广州510080 [2]中山大学附属第一医院转化医学中心,广州510080

出　　处：《中华急诊医学杂志》2016年第1期28-32,共5页Chinese Journal of Emergency Medicine

基　　金：国家自然科学基金（81372023）

摘　　要：目的观察吸人性麻醉药七氟醚对心肺复苏后大鼠心肌保护的作用。方法窒息法建立心脏骤停模型。36只雄性wistar大鼠随机（随机数字法）分为假手术组、七氟醚组、对照组，假手术组仅予麻醉及气管插管，七氟醚组在心肺复苏时即予以1最小肺泡有效浓度（minimum alveolar concentration，MAC）七氟醚吸入，对照组进行常规心肺复苏。每组半数大鼠在自主循环恢复（ROSC）后4h及24h行心脏超声测定心功能。每组剩余大鼠ROSC后4h取材、提取线粒体，分光光度计法评估线粒体通透性转换孔（MPTP）开放程度，Western blot法测定胞质中细胞色素C的表达。结果ROSC后大鼠舒张期左室后壁明显增厚（LVPWd）、心输出量（CO）明显下降。ROSC后4h七氟醚组LVPWd增厚程度（mm）较对照组减轻（1．95±0．14）vs．（2．32±0．34），P〈0．05；心输出量（mL/min）高于对照组（46．94±3．61）vs．（38．77±6.63），P〈0．05；加入氯化钙诱发线粒体肿胀，七氟醚组吸光度下降程度较对照组减轻（0．048±0．007）vs．（0．069±0．011），P〈0.01。心肺复苏后细胞色素C在胞质表达明显增多，七氟醚组胞质中细胞色素C表达较对照组明显减少（1．02±0．22）vs.（1．59±0．31），P〈0．05。结论七氟醚可以改善复苏后心功能不全，下调MPTP开放，减少细胞色素C向胞质的释放。Objective To investigate the effects of sevoflurane on myocardial damage after cardiopulmonary resuscitation in rats. Methods The cardiac arrest model was established by asphyxia. Thirth-six male Wistar rats were assigned to three groups randomly （random number）. Rats in the sham group were anesthetized with intubation, without induced cardiac arrest. Rats in the sevo group inhaled 1minimal alveolar concentration （MAC） of sevoflurane during CPR. Rats in the control group received the standard CPR . At 4 h and 24 h after ROSC , half the rats of every group received the echocardiography examination. At 4 h after ROSC, the rest of rats in every group were sacrificed with overdose anesthetics, the hearts were removed and mitochondria was isolated promptly. Determination of the status of mitochondrial permeability transition pore （MPTP） using the spectrophotometer. The level of cytosolic cytochrome C was measured by Western blot. Results After ROSC, the left ventricular posterior wall during diastolic （LVPWd） became thick and the cardiac output was decreased dramatically. At 4 h after ROSC, the mice of thesevogrouphadaslighterthicknessofLVPWd（mm） （1.95±0.14） vs. （2.32±0.34）, P〈0.05 and an enhanced cardiac output （mL/min） （46.94 ±3.61） vs. （38.77 ±6.63）, P 〈0.05 than the control group. The mitochondria swelling was triggered by the addition of CaCl2 , the sevo group showed an slighter decrease in the absorbance of light compared with the control group （0. 048 ± 0. 007 ） vs. （0. 069 ±0. 011 ）, P 〈0.01. After ROSC, cytochrome C was released to cytosol, and the sevo group had a lower level of this protein than the control group （ 1.02 ±0. 22） vs. （ 1.59±0. 31 ）, P 〈0. 05. Conclusions After ROSC, sevoflnrane can alleviate myocardial dysfunction, attenuate the MPTP opening and decrease the level of cytosolic cytochrome C.

关 键 词：心脏骤停 心肺复苏 窒息 七氟醚 复苏后心功能不全 线粒体通透性转换孔 

分 类 号：R614[医药卫生—麻醉学]