中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2012年
2期
235-238
,共4页
李娟%曹定睿%张劲%李雅慧
李娟%曹定睿%張勁%李雅慧
리연%조정예%장경%리아혜
舒芬太尼%缺血预处理%再灌注损伤%肠%呼吸窘迫综合征,成人%受体,阿片样
舒芬太尼%缺血預處理%再灌註損傷%腸%呼吸窘迫綜閤徵,成人%受體,阿片樣
서분태니%결혈예처리%재관주손상%장%호흡군박종합정,성인%수체,아편양
Sufentanil%Ischemic preconditioning%Reperfusion injury%Intestines%Respiratory distress syndrome,adult%Receptors,opioid
目的 评价舒芬太尼预处理对肠缺血再灌注大鼠急性肺损伤的影响及阿片受体在其中的作用.方法 成年健康雄性Wistar大鼠48只,体重200 ～ 250 g,采用随机数字表法,将其随机分为6组(n=8):假手术组(S组)、肠缺血再灌注组(I/R组)、舒芬太尼预处理组(SPC组)、COTP+ SPC组、NTD+ SPC组和nor-BNI+ SPC组.I/R组、SPC组、COTP+ SPC组、NTD+ SPC组和nor-BNI+ SPC组采用夹闭肠系膜上动脉45 min,再灌注2h的方法制备肠缺血再灌注模型；S组仅分离肠系膜上动脉,不夹闭.SPC组、COTP+ SPC组、NTD+ SPC组和nor-BNI+ SPC组于缺血前10 min时静脉注射舒芬太尼10μg/kg；COTP+ SPC组、NTD+ SPC组于注射舒芬太尼前10 min时分别静脉注射μ受体拮抗剂COTP 1mg/kg或δ受体拮抗剂NTD 5 mg/kg; nor-BNI+ SPC组于注射舒芬太尼前15 min时静脉注射κ受体拮抗剂nor-BNI 5 mg/kg.于再灌注2h时处死大鼠,取肠组织,观察肠粘膜形态并进行肠粘膜损伤评分；取左肺组织,观察肺组织形态并进行肺损伤评分；采用TUNEL法检测肺组织细胞凋亡情况,计算凋亡指数；采用免疫组化法测定肺组织Bcl-2蛋白和Bax蛋白的表达,计算Bcl-2/Bax比值.结果 与S组比较,I/R组、SPC组、COTP+ SPC组、NTD+ SPC组和nor-BNI+ SPC组肠粘膜损伤评分、肺损伤评分和凋亡指数升高,Bcl-2蛋白和Bax蛋白表达上调,Bcl-2/Bax比值降低(P＜0.01)；与I/R组比较,SPC组肠粘膜损伤评分、肺损伤评分和凋亡指数降低,Bcl-2蛋白表达上调,Bax蛋白表达下调,Bcl-2/Bax比值升高(P＜0.01)；与SPC组比较,COTP+ SPC组、NTD+ SPC组和nor-BNI+ SPC组肠粘膜损伤评分、肺损伤评分和凋亡指数升高,Bcl-2蛋白表达下调,Bax表达蛋白表达上调,Bcl-2/Bax比值下降(P＜0.01).结论 舒芬太尼预处理可减轻肠缺血再灌注大鼠急性肺损伤,该作用与激活阿片受体有关.
目的 評價舒芬太尼預處理對腸缺血再灌註大鼠急性肺損傷的影響及阿片受體在其中的作用.方法 成年健康雄性Wistar大鼠48隻,體重200 ～ 250 g,採用隨機數字錶法,將其隨機分為6組(n=8):假手術組(S組)、腸缺血再灌註組(I/R組)、舒芬太尼預處理組(SPC組)、COTP+ SPC組、NTD+ SPC組和nor-BNI+ SPC組.I/R組、SPC組、COTP+ SPC組、NTD+ SPC組和nor-BNI+ SPC組採用夾閉腸繫膜上動脈45 min,再灌註2h的方法製備腸缺血再灌註模型；S組僅分離腸繫膜上動脈,不夾閉.SPC組、COTP+ SPC組、NTD+ SPC組和nor-BNI+ SPC組于缺血前10 min時靜脈註射舒芬太尼10μg/kg；COTP+ SPC組、NTD+ SPC組于註射舒芬太尼前10 min時分彆靜脈註射μ受體拮抗劑COTP 1mg/kg或δ受體拮抗劑NTD 5 mg/kg; nor-BNI+ SPC組于註射舒芬太尼前15 min時靜脈註射κ受體拮抗劑nor-BNI 5 mg/kg.于再灌註2h時處死大鼠,取腸組織,觀察腸粘膜形態併進行腸粘膜損傷評分；取左肺組織,觀察肺組織形態併進行肺損傷評分；採用TUNEL法檢測肺組織細胞凋亡情況,計算凋亡指數；採用免疫組化法測定肺組織Bcl-2蛋白和Bax蛋白的錶達,計算Bcl-2/Bax比值.結果 與S組比較,I/R組、SPC組、COTP+ SPC組、NTD+ SPC組和nor-BNI+ SPC組腸粘膜損傷評分、肺損傷評分和凋亡指數升高,Bcl-2蛋白和Bax蛋白錶達上調,Bcl-2/Bax比值降低(P＜0.01)；與I/R組比較,SPC組腸粘膜損傷評分、肺損傷評分和凋亡指數降低,Bcl-2蛋白錶達上調,Bax蛋白錶達下調,Bcl-2/Bax比值升高(P＜0.01)；與SPC組比較,COTP+ SPC組、NTD+ SPC組和nor-BNI+ SPC組腸粘膜損傷評分、肺損傷評分和凋亡指數升高,Bcl-2蛋白錶達下調,Bax錶達蛋白錶達上調,Bcl-2/Bax比值下降(P＜0.01).結論 舒芬太尼預處理可減輕腸缺血再灌註大鼠急性肺損傷,該作用與激活阿片受體有關.
목적 평개서분태니예처리대장결혈재관주대서급성폐손상적영향급아편수체재기중적작용.방법 성년건강웅성Wistar대서48지,체중200 ～ 250 g,채용수궤수자표법,장기수궤분위6조(n=8):가수술조(S조)、장결혈재관주조(I/R조)、서분태니예처리조(SPC조)、COTP+ SPC조、NTD+ SPC조화nor-BNI+ SPC조.I/R조、SPC조、COTP+ SPC조、NTD+ SPC조화nor-BNI+ SPC조채용협폐장계막상동맥45 min,재관주2h적방법제비장결혈재관주모형；S조부분리장계막상동맥,불협폐.SPC조、COTP+ SPC조、NTD+ SPC조화nor-BNI+ SPC조우결혈전10 min시정맥주사서분태니10μg/kg；COTP+ SPC조、NTD+ SPC조우주사서분태니전10 min시분별정맥주사μ수체길항제COTP 1mg/kg혹δ수체길항제NTD 5 mg/kg; nor-BNI+ SPC조우주사서분태니전15 min시정맥주사κ수체길항제nor-BNI 5 mg/kg.우재관주2h시처사대서,취장조직,관찰장점막형태병진행장점막손상평분；취좌폐조직,관찰폐조직형태병진행폐손상평분；채용TUNEL법검측폐조직세포조망정황,계산조망지수；채용면역조화법측정폐조직Bcl-2단백화Bax단백적표체,계산Bcl-2/Bax비치.결과 여S조비교,I/R조、SPC조、COTP+ SPC조、NTD+ SPC조화nor-BNI+ SPC조장점막손상평분、폐손상평분화조망지수승고,Bcl-2단백화Bax단백표체상조,Bcl-2/Bax비치강저(P＜0.01)；여I/R조비교,SPC조장점막손상평분、폐손상평분화조망지수강저,Bcl-2단백표체상조,Bax단백표체하조,Bcl-2/Bax비치승고(P＜0.01)；여SPC조비교,COTP+ SPC조、NTD+ SPC조화nor-BNI+ SPC조장점막손상평분、폐손상평분화조망지수승고,Bcl-2단백표체하조,Bax표체단백표체상조,Bcl-2/Bax비치하강(P＜0.01).결론 서분태니예처리가감경장결혈재관주대서급성폐손상,해작용여격활아편수체유관.
Objective To evaluate the effect of sufentanil preconditioning on acute lung injury induced by intestinal ischemia-reperfusion (I/R) in rats and the role of opioid receptors.Methods Forty-eight male Wistar rats weighing 200-250 g were randomly divided into 6 groups ( n =8 each):sham operation group (group S) ; I/R group; sufentanil preconditioning group (group SPC) ; COTP (μ receptor antagonist) + SPC group; NTD (δ receptor antagonist) + SPC group and nor-BNI (κ receptor antagonist) + SPC group.Intestinal I/R was produced by occlusion of the superior mesenteric artery for 45 min followed by 2 h reperfusion in groups I/R,SPC,COTP +SPC,NTD + SPC and nor-BNI + SPC.Sufentanil 10 μg/kg was injected intravenously at 10 min before ischemia in groups SPC,COTP + SPC,NTD + SPC and nor-BNI + SPC.COTP 1 mg/kg and NTD 5 mg/kg were injected intravenously at 10 min before sufentanil injection in groups COTP + SPC and NTD + SPC respectively,while nor-BNI 5 mg/kg was injected intravenously at 15 min before sufentanil administration in group nor-BNI + SPC.The animals were sacrificed at 2 h of reperfusion,the intestinal tissue was removed for microscopic examination and intestinal damage was assessed and scored according to Chiu.Left lung tissue was also removed for microscopic examination (1 =normal,4 =severely injured).The apoptosis in lung cells was detected using TUNEL and apoptosis index (AI) was calculated.The expression of Bcl-2 and Bax proteins in lung tissues was detected using immuno-histochemistry and Bcl-2/Bax ratio was calculated.Results Compared with group S,Chiu's score,lung injury score and AI were significantly increased,expression of Bcl-2 and Bax proteins was up-regulated,Bcl-2/Bax ratio was significantly decreased in the other groups ( P ＜ 0.01 ).Compared with group I/R,Chiu' s score,lung injury score and AI were significantly decreased,Bcl-2 protein expression was up-regulated,Bax protein expression was downregulated,and Bcl-2/Bax ratio was significantly increased in group SPC (P ＜ 0.01 ).Compared with group SPC,Chiu's score,lung injury score and AI were significantly increased,Bcl-2 protein expression was down-regulated,Bax protein expression was up-regulated,and Bcl-2/Bax ratio was significantly decreased in groups COTP + SPC,NTD + SPC and nor-BNI + SPC ( P ＜ 0.01 ).Conclusion Sufentanil preconditioning can attenuate lung injury induced by intestinal I/R by activation of opioid receptors in rats.
