舒芬太尼预处理联合咪达唑仑后处理对大鼠心肌缺血-再灌注损伤的影响

发布时间：2018-02-01 19:13

本文关键词： 舒芬太尼咪达唑仑缺血-再灌注模型心肌损伤心肌梗死　出处：《临床麻醉学杂志》2017年10期 　论文类型：期刊论文

【摘要】：目的探讨舒芬太尼预处理联合不同剂量咪达唑仑后处理对大鼠心肌缺血-再灌注(ischemia-reperfusion,IR)损伤的影响。方法 SPF级健康雄性SD大鼠42只,随机分为七组,每组6只。A组:行假手术,穿线不结扎;B0~B5组:构建大鼠心肌IR模型,均结扎0.5h,再灌注2h。其中B0组:未经舒芬太尼和/或咪达唑仑处理;B1组:经舒芬太尼3μg/kg预处理;B2组:经咪达唑仑0.1mg/kg后处理;B3组:经咪达唑仑0.3mg/kg后处理;B4组:经舒芬太尼1.5μg/kg预处理联合咪达唑仑0.05mg/kg后处理;B5组:经舒芬太尼1.5μg/kg预处理联合咪达唑仑0.15mg/kg后处理。经颈静脉,舒芬太尼于缺血前注入,咪达唑仑于缺血后注入。心肌IR结束后测定血清肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、超氧化物歧化酶(SOD)活性和血清丙二醛(MDA)浓度,及炎性因子TNF-α和IL-6浓度。再灌注2h取各组大鼠心脏,测算心肌梗死严重程度(IS/AAR),采用Western blot法检测心肌组织中Bcl-2、Bax及cleaved-caspase-3蛋白含量。结果B0~B5组CK-MB和LDH活性、MDA、TNF-α和IL-6浓度、Bax及cleaved-caspase 3蛋白含量均明显高于A组(P0.05),B1~B5组均明显低于B0组(P0.05),B3和B4组明显低于B2组(P0.05),B5组明显低于B1~B4组(P0.05);B1~B5组IS值及IS/AAR(%)值均明显低于B0组(P0.05),B3和B4组明显低于B2组(P0.05),B5组明显低于B1~B4组(P0.05);B0~B5组SOD活性及Bcl-2含量均明显低于A组(P0.05),B1~B5组均明显高于B0组(P0.05),B3和B4组明显高于B2组(P0.05),B5组明显高于B1~B4组(P0.05)。与B0组比较,B5组CKMB、LDH活性明显下降,SOD活性明显上升,MDA、TNF-α、IL-6浓度明显下降,IS/AAR明显下降,Bcl-2含量增至B0组的2.25倍,Bax含量降至B0组的54.89%,cleaved-caspase-3含量降至B0组的49.67%。结论舒芬太尼预处理联合咪达唑仑后处理可明显减轻大鼠心肌IR损伤,对心肌的保护作用明显优于单独使用时。
[Abstract]:Objective to investigate the effects of sufentanil preconditioning combined with different doses of midazolam postconditioning on myocardial ischemia-reperfusion reperfusion in rats. Methods 42 healthy male SD rats of SPF grade were randomly divided into seven groups: group A (n = 6): sham operation without ligation; Group B _ 0: rat myocardial IR model was established, all rats were ligated for 0.5 h and reperfusion for 2 h. Group B _ 0 was not treated with sufentanil and / or midazolam. Group B1 was pretreated with sufentanil 3 渭 g / kg; Group B2: 0.1 mg / kg after treatment with midazolam; Group B3: after treatment with midazolam 0.3 mg / kg; Group B4 was treated with sufentanil 1.5 渭 g / kg preconditioning combined with midazolam 0.05 mg / kg after treatment. Group B5 was pretreated with sufentanil 1.5 渭 g / kg and midazolam 0.15 mg / kg. Sufentanil was injected into jugular vein before ischemia. Midazolam was injected after ischemia. Serum creatine kinase isoenzyme (CK-MBN) and lactate dehydrogenase (LDH) were measured after IR. The activity of superoxide dismutase (SOD), the concentration of serum malondialdehyde (MDA), and the concentrations of inflammatory cytokines TNF- 伪 and IL-6 were collected at 2h after reperfusion. The severity of myocardial infarction was measured and Bcl-2 in myocardial tissue was detected by Western blot method. Results the activity of MDA-TNF- 伪 and IL-6 in CK-MB and LDH in group B _ 0 and B _ (5) were determined. The protein contents of Bax and cleaved-caspase 3 were significantly higher in group A than those in group A (P 0.05). Group B _ 3 and B _ 4 were significantly lower than group B _ 2 than group B _ 2 (P 0.05) and group B _ (5) were lower than group B _ (1) B _ (4). The values of is and IS-AARA in group B1 / B5 were significantly lower than those in group B0 (P 0.05) and group B 4 (P 0.05). Group B _ 5 was significantly lower than that of group B _ (1) B _ (4) (P 0.05). The activity of SOD and the content of Bcl-2 in group B _ (0) B _ (5) were significantly lower than those in group A (P _ (0.05) and B _ (1) B _ (1) B _ (5) were significantly higher than those in group B _ (0)). Group B _ 3 and B _ 4 were significantly higher than group B _ 2 than group B _ 2 (P 0.05) and group B _ (1) B _ (4) were significantly higher than group B _ (1) B _ (4) (P _ (0.05)). The activity of SOD was significantly increased. The concentration of TNF- 伪 IL-6 in MDA-TNF- 伪 decreased significantly. The content of Bcl-2 increased to 2.25 times of that of B0 group. The content of Bax decreased to 54.89% of group B0. Conclusion Sufentanil preconditioning combined with midazolam post-treatment can significantly reduce myocardial IR injury in rats. The protective effect on myocardium was obviously superior to that of using alone.
【作者单位】：成都军区总医院麻醉科;
【基金】：2016军队后勤科研项目(CCD16J001)
【分类号】：R614
【正文快照】： Influences of sufentanil and midazolam coprocessing on myocardial injury in rats during myocardial is-chemia-reperfusion GONG Gu,CHEN Liang,DAI Xuemei,REN Ling,GU Xuedong,WU Wei.Department of Anesthesiology,General Hospital of Chengdu Military Region of

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