电针预处理对大鼠布比卡因心脏毒性的影响

发布时间：2018-05-03 17:21

本文选题：电针 + 布比卡因　；参考：《兰州大学》2016年硕士论文

【摘要】：目的:布比卡因(bupivacaine)是临床常用的酰胺类局麻药,具有强效、长效的特点。但布比卡因具有很强的心脏毒性,大剂量使用会引起严重的心功能衰竭,甚至室颤、心跳骤停。有证据显示电针(electroacupuncture,EA)治疗可以明显改善心肌缺血再灌注造成的心肌损伤。然而,电针是否可以缓解布比卡因心脏毒性仍然未知。本实验评价电针预处理对布比卡因中毒大鼠心跳停止和复苏结局的影响。方法:SPF级成年雄性SD大鼠36只,体重180~240g,月龄2月,采用随机数字表法,将其分为3组(n=12):布比卡因组(B组)、电针60min组(EA60组)和电针30min组(EA30组)。EA60组和EA30组分别电针双侧内关‖、足三里‖、丰隆‖穴位60min、30min,B组无处理。之后行Ⅱ导联心电图监测、股静脉置管开放静脉通路、颈动脉置管监测动脉血压。电针刺激后3h时静脉匀速注射0.5%布比卡因10 mg/kg,2min给完。发生心跳骤停的大鼠即刻行心肺复苏。用PowerLab系统自动采集布比卡因注射后25min内平均动脉压(mean arterial pressure,MAP)、心率(heart rate,HR)、心电图(Electrocardiograph,ECG),并计量QRS、QT波增宽20%时间,呼吸、心跳停止时间、心跳停止发生率、复苏耗时、最终生存比率等指标。检测布比卡因注射前所有大鼠及注射25min后存活大鼠颈动脉血气,然后取左心室壁心肌组织。采用酶联免疫吸附法检测心肌组织胞浆和线粒体左旋左旋肉碱(L-carnitine,CT)的含量。结果:注射布比卡因后,EA60组大鼠QRS波增宽20%时间高于EA30组和B组(P0.05);EA60组和EA30组心跳停止时间较B组延长(P0.05);布比卡因注射后大部分时间点EA60组血压、心率明显高于EA30组、B组(P0.05);EA60组复苏耗时短于EA30组和B组(P0.05),而EA30组和B组复苏耗时差异无统计学意义(P0.05);注射布比卡因后,B组、EA60组和EA30组大鼠发生心跳停止个数分别为11/12、7/12、10/12,三组大鼠心跳停止发生率差异无统计学意义(P0.05)。复苏结束后,EA60组大鼠最终生存比率(12/12)高于B组(4/12)(P0.05),而EA30组(8/12)和B组最终生存比率差异无显著性意义(P0.05)。B组心肌胞浆CT高于EA60组和EA30组(P0.05);EA60组心肌线粒体CT高于EA30组和B组(P0.05)。结论:电针预处理可提高大鼠对布比卡因中毒耐受性,改善血流动力学水平,提高最终生存比率,且电针60min优于30min。电针预处理作用机制可能与提高左旋肉碱水平而保护线粒体功能有关。
[Abstract]:Objective: bupivacaine (bupivacaine) is an effective and long-acting local anesthetic. But bupivacaine has strong cardiac toxicity, and high dose of bupivacaine can cause severe heart failure, even ventricular fibrillation, cardiac arrest. There is evidence that electroacupuncture can significantly improve myocardial injury caused by myocardial ischemia and reperfusion. However, it remains to be seen whether electroacupuncture can alleviate the cardiac toxicity of bupivacaine. To evaluate the effect of electroacupuncture pretreatment on cardiac arrest and resuscitation in rats with bupivacaine poisoning. Methods Thirty-six adult male SD rats of SPF grade, weighing 180g or 240g, were used for 2 months. They were divided into 3 groups: bupivacaine group (group B), electroacupuncture group (60min group) group (group EA60) and electroacupuncture group (30min group) (group B) and electroacupuncture group (30min group). Group A (group A) and group EA30 (group B) had no treatment at 60 mins and 30 mins, respectively. Then lead II ECG was monitored, femoral vein was inserted to open vein passage, carotid artery was inserted to monitor arterial blood pressure. 0.5% bupivacaine (10 mg 路kg ~ (-1)) was injected intravenously at 3 h after electroacupuncture. Cardiopulmonary resuscitation was performed immediately in rats with cardiac arrest. The mean arterial pressure MAPP, heart rate and heart rate were automatically collected by PowerLab system after bupivacaine injection. The QRSs QT wave width was measured by 20% time, the time of respiration, cardiac arrest, the incidence of cardiac arrest, the time of resuscitation, the survival rate and so on. Carotid blood gas was detected in all rats before bupivacaine injection and in surviving rats after 25min injection, then left ventricular wall myocardial tissue was taken. The contents of L-carnitine L-carnitine in myocardial tissue and mitochondria were detected by enzyme-linked immunosorbent assay (Elisa). Results: after bupivacaine injection, the QRS wave width of rats in group A was 20% longer than that in group EA30 and group B, and the cardiac arrest time in group EA30 and group B was longer than that in group B, and the blood pressure of group EA60 was much higher than that of group B after bupivacaine injection. Heart rate was significantly higher than that in EA30 group B group (P 0.05) and group B was significantly shorter than that in group EA30 and group B (P 0.05), but there was no significant difference between group B and group B in the time of resuscitation (P 0.05). The number of cardiac arrest in group B and group EA30 after bupivacaine injection was significantly higher than that in group B and group B (P 0.05). In 11 / 12 / 7 / 12 / 10 / 12, there was no significant difference in the incidence of cardiac arrest among the three groups (P 0.05). At the end of resuscitation, the final survival rate of rats in EA60 group was higher than that in group B (P 0.05%), but there was no significant difference between group B and group EA30 (P 0.05% 12). There was no significant difference between group B and group B in myocardial cytoplasmic CT (CT) compared with EA60 group and EA30 group (P 0.05%). The myocardial mitochondrial CT in group A was higher than that in group EA30 and group B (P 0.05). Conclusion: electroacupuncture pretreatment can improve the tolerance to bupivacaine poisoning, improve hemodynamics, and improve the survival rate of rats. The electroacupuncture 60min is better than 30 mins. The mechanism of electroacupuncture pretreatment may be related to the protection of mitochondria function by increasing the level of L-carnitine.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R245

【相似文献】