右美托咪定对缺血再灌注离体兔心单相动作电位及突触素表达的影响  

Effect of dexmedetomidine on the Monophasic Action Poten and expression of synaptophysin on ischemia reperfusion of isolated rabbit hearts

作　　者：刘军[1] 高鸿 张凯强[4] 龙娟 李慧[3] Liu Jun;Gao Hong;Zhang Kaiqiang;Long Juan;Li Hui(Department of Cardiac Surgery of Guizhou Provincial People’s Hospital.Guiyang 550004,Guizhou China;Department of anesthesiology of the Affiliated of Guizhou Medical University.Guiyang 550004,Guizhou,China;Department of Anesthesiology,Guizhou Medical University.Guiyang 550004,Guizhou,China;Department of Anesthesiology,Stomatology Hospital,Guizhou Medical University.Guiyang 550004,Guizhou,China)

机构地区：[1]贵州省人民医院心外科,贵州贵阳550001 [2]贵州医科大学附属医院麻醉科,贵州贵阳550004 [3]贵州医科大学麻醉学系,贵州贵阳550004 [4]贵州医科大学附属口腔医院麻醉科,贵州贵阳550004

出　　处：《贵州医药》2019年第10期1525-1528,共4页Guizhou Medical Journal

基　　金：贵阳市科技计划项目(筑科合同[20151001]社31号)

摘　　要：目的观察右美托咪定对家兔离体缺血—再灌注心脏心肌单相动作电位及突触素表达的影响,探讨其对缺血—再灌注心肌心电传导的影响。方法健康成年家兔,体质量(2.0±0.5)kg,成功制备Langendorff离体心脏灌注模型18例,K-H液平衡灌流15min后,随机均分为三组(n=6):空白对照组(C组):持续平衡灌注37℃K-H液150min;缺血—再灌注组(IR组):K-H液继续灌流15min后停灌,注射Thomas液(4℃,10mL/kg)使心脏停搏60min,心脏周围用低温(4℃)Thomas液保护,30min半量复灌Thomas液(4℃,5mL/kg),60min时复灌K-H液;右美托咪定组(DEX组):于K-H液及Thomas液中加入右美托咪定(25ng/mL),余同IR组。记录平衡灌流15min(T0)、继续灌流15min/平衡30min(T1)、复灌30min(T2)/平衡120min、复灌60min/平衡150min(T3)的HR及三层心肌(内膜(Endo)、中膜(Mid)、外膜(Epi))90%单相动作电位时程(monophonic action potential duration,MAPD90),观察心脏复灌时心律失常、复跳时间并记录T2时点三组3层心肌MAP图,免疫组化法检测心肌组织突触素(Synaptophysin,SYN)的表达,三组均不使用药物恢复心律。结果DEX组心脏复跳时间明显短于IR组(P<0.05);心脏复跳时IR组有6例发生心律失常,2min内有2例恢复正常节律;DEX组有2例发生心律失常,2min内有1例恢复正常节律;与T0时比较,IR组T2、T3时HR明显减慢(P<0.05),DEX组T1~T3时HR明显减慢,MAPD90明显增大(P<0.05);与C组比较,T1~T3时DEX组HR明显减慢,MAPD90明显增大(P<0.05);与IR组比较,T1~T3时DEX组HR明显减慢,MAPD90明显增大(P<0.05);SYN表达情况:IR组较C组明显减少(P<0.05),DEX组较IR组表达增多但不及C组(P<0.05)。结论右美托咪定延长MAPD、抑制缺血—再灌注损伤后心肌突触素表达的减少,具有稳定缺血—再灌注心肌心电传导的作用。Objective To observe the effects of dexmedetomidine on the Monophasic Action Poten and expression of synaptophysin on ischemia reperfusion of isolated rabbit hearts,and investigate the effect of ischemia reperfusion myocardium on cardiac electrical conduction. Methods The healthy adult rabbits (2.0±0.5) kg,were randomly divided into 3 groups after Langendorff isolated heart perfusion model has been prepared in 18 cases and K-H fluid has been perfused and balanced 15 min.In the control group (group C),37 ℃ K-H fluid was continuously perfused and balanced for 150 min.In the ischemia/reperfusion group (group I/R),K-H fluid was stopped after perfusion continue filling for 15 min,and then made the cardiac stop for 60min with the injection of Thomas solution (10 mL/kg) while the heart was protected by the low temperature Thomas solution (4 ℃) around.Following the reperfusion of Thomas solution (4 ℃,5 mL/kg) was performed for 30 min and the heart was resuscitated by the perfusion of K-H fluid for 60 min.In dexmedetomidine given group (group DEX).Dexmedetomidine was added in the K-H fluid and the Thomas solution (25 ng/mL).The other procedures were the same as the I/R group.The heart rate (HR),90% monophasic action potential duration (MAPD90) of the three layers of myocardial (endometrium,membrane and epicardial),were recorded at the time of Balance perfusion record 15min (T 0 ),continue perfusion 15 min/balance 30 min (T 1 ),reperfusion 30min /balance 120 min (T 2 ) and reperfusion 60 min/balance 150 min (T 3 ).The arrhythmia and the resuscitation time at cardiac reperfusion were observed,and The MAP map of three groups of three layers of was recorded at T 2 time point.And was detected expression of synaptophysin (Synaptophysin,SYN) of myocardial tissue by immunohistochemical method.Not using drugs to restore heart rhythm. Results Group DEX cardiac resuscitation time was significantly shorter than group IR ( P <0.05).At the recovery of heart beating,group IR,six cases of arrhythmia,there were two cases within 2 m

关 键 词：右美托咪定 缺血-再灌注损伤 单相动作电位 离体心脏 电生理学技术 突触素 

分 类 号：R654.2[医药卫生—外科学]