CAJ | 학술논문

目的评价瑞芬太尼预先给药对兔心肌缺血再灌注损伤的影响.方法健康家兔30只,月龄12～18个月,体重2.5～3.5kg,随机分为3组(n=10):缺血再灌注组(IR组)、低剂量瑞芬太尼预先给药组(R1组)和高剂量瑞芬太尼预先给药组(R2组).3组均采用结扎左冠状动脉前降支30 min开放的方法制备心肌缺血再灌注模型,R1组和R2组分别静脉输注瑞芬太尼1.65、3.30μg·kg-1·min-130 min时进行缺血,IR组给予等容量生理盐水.于给药前(基础状态)、给药结束时、缺血30 min、再灌注6 h时采集静脉血样,测定血清心肌肌钙蛋白I(cTnI)和MB型肌酸激酶同工酶(CK-MB)的浓度.再灌注结束时处死动物,取心肌组织,光镜和电镜下观察病理学结果.结果与IR组比较,R1组和R2组血清cTnI和CK-MB浓度降低(P＜0.01);与R1组比较,R2组血清cTnI浓度降低(P＜0.01).R1组和R2组心肌病理学损伤程度均轻于IR组,且R2组心肌病理学损伤程度轻于R1组.结论瑞芬太尼预先给药可减轻兔心肌缺血再灌注损伤,且与剂量有关.
목적 평개서분태니예선급약대토심기결혈재관주손상적영향.방법 건강가토30지,월령12～18개월,체중2.5～3.5kg,수궤분위3조(n=10):결혈재관주조(IR조)、저제량서분태니예선급약조(R1조)화고제량서분태니예선급약조(R2조).3조균채용결찰좌관상동맥전강지30 min개방적방법제비심기결혈재관주모형,R1조화R2조분별정맥수주서분태니1.65、3.30μg·kg-1·min-130 min시진행결혈,IR조급여등용량생리염수.우급약전(기출상태)、급약결속시、결혈30 min、재관주6 h시채집정맥혈양,측정혈청심기기개단백I(cTnI)화MB형기산격매동공매(CK-MB)적농도.재관주결속시처사동물,취심기조직,광경화전경하관찰병이학결과.결과 여IR조비교,R1조화R2조혈청cTnI화CK-MB농도강저(P＜0.01);여R1조비교,R2조혈청cTnI농도강저(P＜0.01).R1조화R2조심기병이학손상정도균경우IR조,차R2조심기병이학손상정도경우R1조.결론 서분태니예선급약가감경토심기결혈재관주손상,차여제량유관.
Objective To investigate the effects of remffentanil pretreatment on myocardial ischemiareperfusion (I/R) injury in rabbits. Methods Thirty healthy rabbits, aged 12-18 months, weighing 2.5-3.5 kg,were randomly divided into 3 groups (n = 10 each): I/R group, low-dose remifentanil pretreatment group (group R1 ) and high-dose remifentanil pretreatment group (group R2 ). Myocardial I/R was induced by ligation of anterior descending branch of left coronary artery for 30 min followed by 6 h of reperfusion in the 3 groups. Remifentanil was infused intavenously at 1.65 and 3.30 μg· kg - 1 · min- 1 for 30 min before ischemia in group R1 and R2 respectively, while equal volume of normal saline was infused instead in group I/R. Blood samples were taken for determination of serum cardiac troponin-Ⅰ (cTnI) and creatine kinase-MB isoenzyme (CK-MB) concentrations before administration (baseline), after administration, at 30 min of ischemia and at 6 h of reperfusion. The rabbits were then sacrificed and hearts removed. Myocardial tissues were obtained for microscopic examination. Results Serum cTnI and CK-MB concentrations were significantly lower in group R1 and R2 than in group I/R and serum cTnI concentration lower in group R2 than in group R1 ( P ＜ 0.01). Remifentanil infusion significantly attenuated the pathologic changes in a dose-dependent manner. Conclusion Remifentanil pretreatment provides protective effect against myocardial I/R injury in rabbits and it is related to the dose.