CAJ | 학술논문

目的评价瑞芬太尼后处理及其联合异丙酚后处理对大鼠肝脏缺血再灌注损伤的影响.方法健康雄性SD大鼠30只,体重220 ～ 280 g,采用随机数字表法,将其随机分为5组(n=6):假手术组(Ⅰ组)、缺血再灌注组(Ⅱ组)、异丙酚后处理组(Ⅲ组)、瑞芬太尼后处理组(Ⅳ组)和异丙酚联合瑞芬太尼后处理组(Ⅴ组).Ⅱ组～Ⅴ组采用夹闭门静脉和肝动脉30 min的方法制备肝脏缺血再灌注损伤模型,Ⅰ组仅开腹.Ⅲ组、Ⅳ组和Ⅴ组再灌注即刻分别静脉输注异丙酚30 mg· kg-1·h-1、瑞芬太尼1μg·kg -1·min -1和异丙酚30 ng·kg-1·h-1+瑞芬太尼1μg·kg-1·min-1 1 h,Ⅱ组给予等容量生理盐水.于再灌注1h时采集静脉血样,测定血清AST、ALT活性、IL-8、IL-10的浓度,然后处死大鼠,取肝组织,测定肝细胞c-fos和c-jun表达,电镜下观察肝组织病理学结果.结果与Ⅰ组比较,Ⅱ组～Ⅴ组血清AST、ALT活性及IL-8、IL-10的浓度升高,肝细胞c-fos和c-jun表达上调(P＜0.05或0.01)；与Ⅱ组比较,Ⅲ组～Ⅴ组血清AST、ALT活性及IL-8浓度降低,IL-10浓度升高,肝细胞c-fos和c-jun表达下调(P ＜0.05或0.01)；与Ⅲ组及Ⅳ组比较,Ⅴ组上述指标差异无统计学意义(P＞0.05).Ⅲ组～Ⅴ组肝组织病理学损伤程度明显轻于Ⅱ组.结论瑞芬太尼后处理可减轻大鼠肝脏缺血再灌注损伤,联合异丙酚后处理时其效应与单独一种方法的效应相似,其机制与抑制炎性反应和肝细胞凋亡有关.
목적 평개서분태니후처리급기연합이병분후처리대대서간장결혈재관주손상적영향.방법 건강웅성SD대서30지,체중220 ～ 280 g,채용수궤수자표법,장기수궤분위5조(n=6):가수술조(Ⅰ조)、결혈재관주조(Ⅱ조)、이병분후처리조(Ⅲ조)、서분태니후처리조(Ⅳ조)화이병분연합서분태니후처리조(Ⅴ조).Ⅱ조～Ⅴ조채용협폐문정맥화간동맥30 min적방법제비간장결혈재관주손상모형,Ⅰ조부개복.Ⅲ조、Ⅳ조화Ⅴ조재관주즉각분별정맥수주이병분30 mg· kg-1·h-1、서분태니1μg·kg -1·min -1화이병분30 ng·kg-1·h-1+서분태니1μg·kg-1·min-1 1 h,Ⅱ조급여등용량생리염수.우재관주1h시채집정맥혈양,측정혈청AST、ALT활성、IL-8、IL-10적농도,연후처사대서,취간조직,측정간세포c-fos화c-jun표체,전경하관찰간조직병이학결과.결과 여Ⅰ조비교,Ⅱ조～Ⅴ조혈청AST、ALT활성급IL-8、IL-10적농도승고,간세포c-fos화c-jun표체상조(P＜0.05혹0.01)；여Ⅱ조비교,Ⅲ조～Ⅴ조혈청AST、ALT활성급IL-8농도강저,IL-10농도승고,간세포c-fos화c-jun표체하조(P ＜0.05혹0.01)；여Ⅲ조급Ⅳ조비교,Ⅴ조상술지표차이무통계학의의(P＞0.05).Ⅲ조～Ⅴ조간조직병이학손상정도명현경우Ⅱ조.결론 서분태니후처리가감경대서간장결혈재관주손상,연합이병분후처리시기효응여단독일충방법적효응상사,기궤제여억제염성반응화간세포조망유관.
Objective To investigate the effects of remifentanil postconditioning and combined remifentanil-prupofol postconditioning on liver ischemia-reperfusion (I/R) injury in rats.Methods Thirty male SD rats weighing 220-280 g were randomly divided into 5 groups ( n =6 each):group sham operation (group Ⅰ ) ; group I/R (group Ⅱ ) ; group propofol postconditioning (group Ⅲ ) ; group remifentanil postconditioning (group Ⅳ ) and group combined propofol-remifentanil postconditioning (group Ⅴ ).In groups Ⅱ- Ⅴ the hepatic arteries and veins of middle and left were occluded for 30 min.In groups Ⅲ-Ⅴ propofol ( at 30 mg· kg- 1 · h - 1 ) and/or remifentanil (at 1 μg· kg- 1 · min- 1 ) were infused iv at the onset of reperfusion for 1 h.Blood samples were taken at the end of 1 h reperfusion for determination of serum AST,ALT activities and IL-8,IL-10 concentrations.The animals were sacrificed after blood sampling.Liver specimens were obtained for determination of c-fos and c-jun expression in liver cells by immuno-histochemistry and microscopic examination with scanning electron microscope.Results Liver I/R significantly increased serum AST and ALT activities and IL-8 and IL-10 concentrations and c-fos and cjun expression in liver ceils in group Ⅱ as compared with group Ⅰ.The serum AST and ALT activities,IL-8 concentration and the c-fos and c-jun expression in liver cells were significantly lower.and the serum IL-10 concentration was significantly higher in groups Ⅲ- Ⅴ than in group Ⅱ,but there were no significant differences among the groups Ⅲ - Ⅴ.The histo-pathological changes in the liver tissue were significantly attenuated in groups Ⅲ- v as compared with group Ⅱ.Conclusion Postconditioning with remifentanil and/or propofol can attenuate liver I/R injury by inhibiting inflammatory response and apoptosis in the liver cells,but there is no significant difference in the protective effects induced by postconditioning with remifentanil or propofol alone or in combination.