异氟醚预处理对兔心肌缺血再灌注损伤的保护作用及机制  

Protective effect and mechanism of isoflurane induced preconditioning on ischemia-reperfusion injury in rabbit hearts

作　　者：姚立农[1] 柴伟[1] 赵晖[1] 杨永慧[1] 

机构地区：[1]第四军医大学唐都医院麻醉科,陕西西安710038

出　　处：《第四军医大学学报》2002年第15期1360-1362,共3页Journal of the Fourth Military Medical University

摘　　要：目的　探讨麻醉药异氟醚预处理对兔心缺血再灌注损伤的保护作用及机制 .方法　将兔 4 0只造成在体局部心肌缺血再灌注模型 ,随机分成 4组 (n=10 ) .对照组无预处理 ;5 - HD组在缺血前 4 0 min给予 5 - HD5 mg· kg- 1 ;异氟醚预处理组给予 10 m L· L- 1 异氟醚 (呼气末 ) 15 min.异氟醚 +5 - HD组以上述方法同时给予异氟醚和 5 - HD.实验中持续监测左室收缩压 (L VSP)、左室舒张末压 (L VEDP)、左室内收缩压最大上升速率 (+dp/ dtmax)和心率 (HR)的变化 ,再灌注结束后用伊文蓝和 TTC染色法确定缺血和梗死心肌范围 .结果　与对照组和 5 - HD组比较 ,缺血前异氟醚降低 L VSP和+dp/ dtmax(P<0 .0 5 ) ,再灌注期各组血流动力学参数无明显差异 .各组梗死范围占左室质量的百分数分别是 (18± 6 ) % ,(2 0± 9) % ,(7± 4 ) %和 (17± 4 ) % ,与其余 3组比较异氟醚预处理显著降低缺血心肌的梗死范围 (P<0 .0 5 ) .对照组、5 -HD组和异氟醚 +5 - HD组无统计差异 (P>0 .0 5 ) .结论　异氟醚预处理对兔心肌缺血再灌注损伤有明显的保护作用 ,其机制可能与线粒体 K+ 　 ATP通道有关 .AIM To investigate the protective effects and the mechanisms of isoflurane induced preconditioning on ische mia reperfusion injury in rabbit hearts. METHODS Fortyrabbits were modelled as the reperfusion injury of ischemic myocardium and randomly divided into 4 groups. The control group received no pretreatment. 5 hydroxydecanoate (5 HD) group was given only 5 mg·kg -1 5 HD 40 min before ischemia . Isoflurane preconditioned group was pretreated with end tidal 10 mL·L -1 isoflurane 15 min. Isoflurane plus 5 HD group received 5 HD 10 min before isoflurane. The LVSP, +dp/dt max , LVEDP and heart rate (HR) were recorded during the experiment. At the end of the reperfusion, infarct size and area at risk were defined by TTC staining. RESULTS Isoflurane decreased LVSP and +dp/dt max compared with the control and 5 HD groups ( P <0.05) before ischemia, but there was no significant difference between the four groups during the reperfusion. Isoflurane significantly reduced myocardial infarct size in the isoflurane group compared with the control, 5 HD and isoflurane+5 HD groups ( P < 0.05 ). The infarct size were (7±4)%, (18±6)%, (20±9)%, and (17±4)% respectively. There was no difference between the latter three groups ( P >0.05). CONCLUSION Isoflurane induced preconditioning provides significant myocardial protection against ischima reperfusion injury in vivo rabbit hearts and mitochondrial K + ATP channels is likely involved in this protective mechanism.

关 键 词：异氟醚 预处理 心肌缺血 再灌注损伤 保护作用 线粒体K^+ATP通道 

分 类 号：R542.2[医药卫生—心血管疾病] R971.2[医药卫生—内科学]