CAJ | 학술논문

目的探讨阿片受体在异氟醚延迟预处理减轻兔心肌缺血再灌注损伤中的作用.方法健康雄性新西兰大白兔40只,体重2.0～2.5 kg,采用结扎左冠状动脉前降支40 min,再灌注120 min的方法制备心肌缺血再灌注损伤模型,随机分为4组(n=10):假手术组(S组)吸入纯氧2 h,24 h后仅动脉下穿线不结扎;心肌缺血再灌注组(IR组)吸入纯氧2 h,24 h后行心肌缺血再灌注;异氟醚延迟预处理组(I组)吸人2%异氟醚2 h,24 h后行心肌缺血再灌注;阿片受体阻断剂+异氟醚延迟预处理组(N组)静脉注射纳洛酮6 mg/kg后10 min,吸入2%异氟醚2 h,24 h后行心肌缺血再灌注.于再灌注120 min时取心脏,计算心肌缺血面积和梗死面积,测定磷酸化p38MAPK蛋白表达水平,观察心肌细胞超微结构.结果 S组心肌细胞完整,排列整齐,线粒体形态正常,糖原丰富;IR组和N组心肌细胞水肿,心肌纤维排列紊乱,线粒体、内质网膜水肿,空泡化;I组心肌细胞水肿程度减轻,心肌纤维排列较完整,线粒体轻度水肿.与IR组比较,I组心肌梗死面积减小,磷酸化p38MAPK蛋白表达下调(P<0.05),N组上述指标差异无统计学意义(P>0.05).结论阿片受体参与异氟醚延迟预处理减轻兔心肌缺血再灌注损伤.
목적 탐토아편수체재이불미연지예처리감경토심기결혈재관주손상중적작용.방법 건강웅성신서란대백토40지,체중2.0～2.5 kg,채용결찰좌관상동맥전강지40 min,재관주120 min적방법제비심기결혈재관주손상모형,수궤분위4조(n=10):가수술조(S조)흡입순양2 h,24 h후부동맥하천선불결찰;심기결혈재관주조(IR조)흡입순양2 h,24 h후행심기결혈재관주;이불미연지예처리조(I조)흡인2%이불미2 h,24 h후행심기결혈재관주;아편수체조단제+이불미연지예처리조(N조)정맥주사납락동6 mg/kg후10 min,흡입2%이불미2 h,24 h후행심기결혈재관주.우재관주120 min시취심장,계산심기결혈면적화경사면적,측정린산화p38MAPK단백표체수평,관찰심기세포초미결구.결과 S조심기세포완정,배렬정제,선립체형태정상,당원봉부;IR조화N조심기세포수종,심기섬유배렬문란,선립체、내질망막수종,공포화;I조심기세포수종정도감경,심기섬유배렬교완정,선립체경도수종.여IR조비교,I조심기경사면적감소,린산화p38MAPK단백표체하조(P<0.05),N조상술지표차이무통계학의의(P>0.05).결론 아편수체삼여이불미연지예처리감경토심기결혈재관주손상.
Objective To investigate the role of opioid receptors in the protective effects of isoflurane-induced delayed preconditioning against myocardial ischemia-reperfusion (I/R) injury in rabbits. Methods Forty male New Zealand white rabbits weighing 2.0-2.5 kg were randomly assigned into 4 groups ( n = 10 each) : group I sham operation (S); group II I/R; group Ⅲ isoflurane + I/R (Iso) and group IV Iso + naloxone + I/R (Nal). Myocardial I/R was induced by 40 min occlusion of left anterior descending branch (LAD) of coronary artery followed by 120 min reperfusion. In group Ⅲ (Iso) 2% isoflurane in 100% O2 was inhaled for 2 h and I/R was produced 24 h later. In group IV (Nal) naloxone 6 mg/kg was given iv 10 min before 2 h of 2% isoflurane inhalation and I/R was produced 24 h later. At the end of 120 min reperfusion, infarct size (IS) and area at risk (AAR) were determined by Evan's blue and TTC staining. Myocardial ultrastructure was examined by electron microscopy. The phosphorylated p38MAPK protein expression in myocardium was determined by Western blot. Results The IS was significantly smaller in group Iso ( Ⅲ ) ( 19.7% ± 2.8%) than in I/R group ( II ) (37.8% ±1.7%) (P<0.05). The phosphorylated p38MAPK protein expression in myocardium was significantly lower in group Iso than in group I/R. Microscopic examination showed less myocardial damage in Iso group than in group I/R. The protective effects of delayed preconditioning by isoflurane was prevented by naloxone pretreatment. ConclusionOpioid receptors may be involved in the protective effects of delayed preconditioning by isoflurane against myocardial I/R injury.