右美托咪定对猪体外循环下心肌线粒体功能的影响  

Effect of Dexmedetomidine on myocardial mitochondrial function under cardiopulmonary bypass in pigs

作　　者：吴建江[1] 戴晓雯[1] 王江[1] Wu Jianjiang;Dai Xiaowen;Wang Jiang(Department of Anesthesiology,First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院麻醉科,乌鲁木齐830054

出　　处：《中国体外循环杂志》2021年第3期179-182,187,共5页Chinese Journal of Extracorporeal Circulation

基　　金：新疆维吾尔自治区重点实验室开放课题(2017D04007)。

摘　　要：目的探讨右美托咪定(Dex)对小型猪心肺转流(CPB)心肌缺血/再灌注损伤线粒体功能的影响。方法将12只小型猪随机分为两组,分别为CPB组(T组)和CPB+Dex组(D组)。D组在麻醉诱导前均予以1μg/kg的Dex输注,速率为0.5μg/(kg·h)。比较两组麻醉前(T0)、CPB建立后(T1)、心脏复跳后5 min(T2)、心脏复跳后60 min(T3)和心脏复跳后120 min(T4)心脏功能的变化,以及心脏复跳后测定血清中心肌损伤指标、氧化应激损伤和线粒体能量代谢的变化。结果与T组比较,D组小型猪在T0~T4心脏功能明显改善。与T组比较,D组血清中肌酸激酶同工酶和肌钙蛋白I降低、改善心肌细胞超微结构、提高Mn-过氧化物岐化酶水平、增加线粒体三磷酸腺苷含量、降低线粒体活性氧簇产生率(P<0.05)。结论1μg/kg Dex并以0.5μg/(kg·h)的速率输注能有效减轻CPB对小型猪的心肌损伤和线粒体功能障碍。Objective To investigate the effect of dexmedetomidine(Dex)on myocardial ischemia/reperfusion injury in minipigs with cardiopulmonary bypass(CPB).Methods Twelve miniature pigs were randomly divided into 2 groups:the CPB group(T group)and the CPB+Dex group(D group).In group D,1μg/kg Dex was infused before induction of anesthesia at a rate of 0.5μg/(kg·h).Then,we compared the changes of cardiac function in the two groups before anesthesia(T0),after the establishment of CPB(T1),5 min(T2),60 min(T3)and 120 min(T4)after the heart beat resumed,and measured the serum myocardium damage indicators,oxidative stress damage and changes in mitochondrial energy metabolism after heart resuscitation.Results Compared with the T group,the cardiac function of miniature pigs in the D group was significantly improved before anesthesia,after the establishment of CPB,as well as at 5 min,60 min and 120 min after the heart beat resumed.Compared with group T,serum creatine kinase isoenzyme and troponin I decreased in group D,which improved the ultrastructure of cardiomyocytes,increased the level of Mn-peroxide dismutase and the content of mitochondria ATP,and decreased the production rate of mitochondrial reactive oxygen species(P<0.05).Conclusion Infusion of 1μg/kg Dex at a rate of 0.5μg/(kg·h)can effectively alleviate myocardial injury and mitochondrial dysfunction in pigs with CPB.

关 键 词：右美托咪定 猪 心肺转流 缺血/再灌注损伤 线粒体功能 心肌损伤 心肌保护 

分 类 号：R614[医药卫生—麻醉学]