CAJ | 학술논문

目的探讨糖尿病因素对舒芬太尼后处理减轻大鼠心肌缺血再灌注损伤的影响.方法健康成年雄性SD大鼠,体重250～300 g,采用腹腔注射链脲佐菌素50 mg/kg的方法制备糖尿病模型.取造模成功的大鼠30只,采用随机数字表法,将其随机分为3组(n＝10):糖尿病假手术组(DM-S组)、糖尿病缺血再灌注组(DM-IR组)和糖尿病舒芬太尼后处理组(DM-SP组).另取正常大鼠30只,采用随机数字表法,将其随机分为3组(n=10):非糖尿病假手术组(NDM-S组)、非糖尿病缺血再灌注组(NDM-IR组)和非糖尿病舒芬太尼后处理组(NDM-SP组).采用结扎左冠状动脉前降支30 min后再灌注的方法制备心肌缺血再灌注模型.SP组于再灌注前5 min经颈静脉注射舒芬太尼1.0 μg/kg.于缺血前、缺血30 min和再灌注120 min时记录MAP、SBP和HR,计算收缩压心率乘积(RPP).再灌注120 min时取血样,测定血浆cTnI浓度,处死大鼠后,取心脏,测定左右心室体积之和、缺血危险区体积(AAR)和梗死区体积(IS),计算IS/AAR.结果非糖尿病和糖尿病大鼠心肌缺血再灌注时MAP、RPP降低,血浆cTnI浓度升高,心肌发生梗死样改变.舒芬太尼后处理可降低非糖尿病大鼠心肌缺血再灌注时IS、IS/ARR和血浆cTnI浓度,对糖尿病大鼠心肌缺血再灌注时各指标无明显影响.DM-SP组IS、IS/ARR和血浆cTnI浓度明显高于NDM-SP组(P＜0.05).结论糖尿病因素可消除舒芬太尼后处理减轻大鼠心肌缺血再灌注损伤的作用.
목적 탐토당뇨병인소대서분태니후처리감경대서심기결혈재관주손상적영향.방법 건강성년웅성SD대서,체중250～300 g,채용복강주사련뇨좌균소50 mg/kg적방법제비당뇨병모형.취조모성공적대서30지,채용수궤수자표법,장기수궤분위3조(n＝10):당뇨병가수술조(DM-S조)、당뇨병결혈재관주조(DM-IR조)화당뇨병서분태니후처리조(DM-SP조).령취정상대서30지,채용수궤수자표법,장기수궤분위3조(n=10):비당뇨병가수술조(NDM-S조)、비당뇨병결혈재관주조(NDM-IR조)화비당뇨병서분태니후처리조(NDM-SP조).채용결찰좌관상동맥전강지30 min후재관주적방법제비심기결혈재관주모형.SP조우재관주전5 min경경정맥주사서분태니1.0 μg/kg.우결혈전、결혈30 min화재관주120 min시기록MAP、SBP화HR,계산수축압심솔승적(RPP).재관주120 min시취혈양,측정혈장cTnI농도,처사대서후,취심장,측정좌우심실체적지화、결혈위험구체적(AAR)화경사구체적(IS),계산IS/AAR.결과 비당뇨병화당뇨병대서심기결혈재관주시MAP、RPP강저,혈장cTnI농도승고,심기발생경사양개변.서분태니후처리가강저비당뇨병대서심기결혈재관주시IS、IS/ARR화혈장cTnI농도,대당뇨병대서심기결혈재관주시각지표무명현영향.DM-SP조IS、IS/ARR화혈장cTnI농도명현고우NDM-SP조(P＜0.05).결론 당뇨병인소가소제서분태니후처리감경대서심기결혈재관주손상적작용.
Objective To investigate effect of diabetes mellitus factor on attenuation of myocardial ischemia-reperfusion injury by sufentanil postconditioning in rats.Methods Diabetes mellitus was established by intraperitoneal streptozotocin 50 mg/kg and was confirmed by blood glucose ≥ 16.7 mmol/L.Thirty healthy adult male SD rats,weighing 250-300 g which diabetes mellitus model was successfully established were randomly divided into 3 groups ( n =10 each):diabetic mellitus sham operation group (group DM-S),diabetic mellitus ischemia-reperfusion group (group DM-IR) and diabetic meltitus sufentanil postconditioning group (group DM-SP).Another 30nondiabetic mellitus rats were also randomly divided into 3 group ( n =10 each):nondiabetic mellitus sham operation group (group NDM-S),nondiabetic mellitus ischemia-reperfusion group (group NDM-IR) and nondiabetic mellitus sufentanil postconditioning group (group NDM-SP).Myocardial ischemia-reperfusion was induced by 30 min occlusion of left anterior descending branch of coronary artery followed by reperfusion.Sufentanil postconditioning was induced by iv injection of sufentanil 1.0 μg/kg at 5 min before reperfusion.MAP,SBP,HR and RPP (HR × SBP) were recorded before ischemia,30 min of ischemia and 120 min of reperfusion.Arterial blood samples were collected at 120 min of reperfusion for measurement of plasma cardiac troponin 1 (cTnI) concentration.The animals were then sacrificed for determination of total areas of right and left ventricles ( LV + RV),infarct area (IS),area at risk (AAR) and IS/AAR.Results MAP and RPP were significantly lower,while plasma cTnI concentration was higher during myocardial ischemia reperfusion in diabetic and nondiabetic rats.Sufentanil postconditioning significantly decreased IS,IS/AAR and plasma cTnI concentration in nondiabetic rats during myocardial ischemia reperfusion but had no effect on IS,IS/AAR and plasma cTnI concentration in diabetic rats.The IS,IS/AAR and plasma cTnI concentration were significantly higher in DM-SP group than in NDM-SP gnoup ( P ＜ 0.05).Conclusion Diabetes mellitus factor can negate sufentanil postconditioning induced protection against myocardial ischemia-reperfusion injury in rats.