体外循环期间应用右美托咪定对猪外周血单核细胞TLR-4,5/NF-κB信号通路的影响  

Effect of dexmedetomidine on TLR-4,5/NF-κB signal pathway in swine peripheral blood mononuclear cells during cardiopulmonary bypass

作　　者：罗琳[1] 魏晓[1] 陈梅珠[1] 李美霞[1] LUO Lin;WEI Xiao;CHEN Meizhu;LI Meixia(Department of Anesthesiology,Haikou Municipal Hospital,Haikou 570208,China)

机构地区：[1]中南大学湘雅医学院附属海口医院,海口市人民医院,海口570208

出　　处：《实用医学杂志》2018年第22期3774-3778,共5页The Journal of Practical Medicine

基　　金：海南省自然科学基金(编号:2017817385).

摘　　要：目的探讨右美托咪定对猪体外循环(CPB)期间外周血单核细胞TLR-4,5/NF-κB信号通路的影响。方法实验选择五指山小型猪20头,随机分为4组(n=5):右美托咪定组(D组),右美托咪定+育亨宾组(DY组),育亨宾组(Y组),对照组(C组)。D组和DY组在麻醉诱导前静脉输注右美托咪定1μg/kg,随后以0.5μg/(kg·h)速率维持至手术结束;DY组在静脉输注右美托咪定前给予育亨宾l mg/kg;Y组和C组在麻醉诱导前分别给予育亨宾1 mg/kg和等量生理盐水。在CPB前(T_0)、CPB后1(T_1)及2 h(T_2)、停CPB后1(T_3)及2 h(T_4),采集血标本检测外周血CD16^+单核细胞TLR4、5和NF-κB的阳性表达率,血浆中TNF-α浓度。结果与D组比较,C组和DY组在T_(1-4)时点外周血CD16^+单核细胞TLR4、5和NF-κB阳性表达率,血浆中TNF-α浓度均增高。结论右美托咪定通过兴奋α_2肾上腺素受体,抑制TLR-4,5/NF-κB信号通路的激活从而减轻体外循环诱发的全身炎症反应。Objective To evaluate the effect of dexmedetomidine on TLR-4,5/NF-κB signal pathway in swine peripheral blood mononuclear cells during cardiopulmonary bypass(CPB).Methods Twenty swine were randomly divided into 4 groups(n=5 each):dexmedetomidine group(group D),dexmedetomidine+Yohimbine group(group DY),Yohimbine group(group Y),and control group(group C).In group D and group DY,1.0μg/kg bolus dose of dexmedetomidine were administered before the induction of anesthesia,followed by 0.5μg/(kg·h)infusion until the end of surgery;in group DY,1.0 mg/kg dose of Yohimbine was administered before infusing dex-medetomidine;in group Y,only 1.0 mg/kg dose of Yohimbine was administered before the induction of anesthe-sia,while in group C equal volume of normal saline was infused instead of dexmedetomidine.Blood samples were collected to detect the positive expression rate of toll-like receptor 4 and 5(TLR4,5)and nuclear factor KappaB(NF-κB)in peripheral blood CD16^+mononuclear cells before CPB(T0),1 h,2 h after CPB(T1-2)and 1 h,2 h after termination of CPB(T3-4),and so did the measurement of the concentrations of tumor necrosis factor-alpha(TNF-α),interleukin-6(IL-6),and interleukin-10(IL-10)in plasma.Result Compared to group D,the posi-tive expression rate of TLR4,5 and NF-κB in peripheral blood CD16^+mononuclear cells were significantly increased in group C and DY,the concentrations of TNF-α,IL-6 were significantly increased and the concentra-tions of IL-10 were significantly decreased in group C and group DY at 1 h,2 h after CPB(T1-2)and 1 h,2 h after termination of CPB(T3-4)(P≤0.05).Conclusion Dexmedetomidine can reduce inflammatory response in CPB.The mechanism is related to the inhibition of the activation of TLR-4,5/NF-κB signal pathway by excitedα2 adren-ergic receptors.

关 键 词：右美托咪定 体外循环 TOLL样受体 核转录因子ΚB 育亨宾 

分 类 号：R614[医药卫生—麻醉学]