CAJ | 학술논문

目的探讨不同剂量瑞芬太尼对大鼠肾脏缺血再灌注损伤的影响.方法健康成年雄性SD大鼠60只,体重220～250 g,采用随机数字表法,将大鼠随机分为5组(n=12):假手术组(S组)、模型组(M组)、低、中和高剂量瑞芬太尼组(RL组、RM组和RH组).除S组外均采用夹闭双侧肾动脉45 min后恢复再灌注法建立肾脏缺血再灌注模型.RL组、RM组和RH组于缺血前15min分别经尾静脉输注瑞芬太尼0.2、0.6、1.0μg·kg-1·min-1至再灌注30 min;S组和M组给予等容量生理盐水替代.于再灌注30 min及24 h时经股静脉采集血样1 ml,测定血清BUN及Cr浓度;于再灌注24h时取肾组织,测定MDA含量及SOD、Ca2+-ATP酶活性,光、电镜下观察肾组织病理学结果.结果与S组比较,其余4组血清BUN和Cr浓度、肾组织MDA含量升高,SOD和Ca2+-ATP酶活性降低(P＜0.05或0.01),肾组织有不同程度的病理学损伤.与M组比较,RL组、RM组和RH组血清BUN和Cr浓度、肾组织MDA含量降低,SOD和Ca2+-ATP酶活性升高(P＜0.05或0.01),肾组织病理学损伤减轻o RL组、RM组和RH组随瑞芬太尼剂量增加,血清BUN和Cr浓度、肾组织MDA含量逐渐降低,SOD和Ca2+-ATP酶活性逐渐升高(P＜0.05或0.01),肾组织病理学损伤逐渐减轻.结论瑞芬太尼可减轻大鼠肾脏缺血再灌注损伤,且与剂量有关,其机制与抑制脂质过氧化反应、提高Ca2+-ATP酶活性有关.
목적 탐토불동제량서분태니대대서신장결혈재관주손상적영향.방법 건강성년웅성SD대서60지,체중220～250 g,채용수궤수자표법,장대서수궤분위5조(n=12):가수술조(S조)、모형조(M조)、저、중화고제량서분태니조(RL조、RM조화RH조).제S조외균채용협폐쌍측신동맥45 min후회복재관주법건립신장결혈재관주모형.RL조、RM조화RH조우결혈전15min분별경미정맥수주서분태니0.2、0.6、1.0μg·kg-1·min-1지재관주30 min;S조화M조급여등용량생리염수체대.우재관주30 min급24 h시경고정맥채집혈양1 ml,측정혈청BUN급Cr농도;우재관주24h시취신조직,측정MDA함량급SOD、Ca2+-ATP매활성,광、전경하관찰신조직병이학결과.결과 여S조비교,기여4조혈청BUN화Cr농도、신조직MDA함량승고,SOD화Ca2+-ATP매활성강저(P＜0.05혹0.01),신조직유불동정도적병이학손상.여M조비교,RL조、RM조화RH조혈청BUN화Cr농도、신조직MDA함량강저,SOD화Ca2+-ATP매활성승고(P＜0.05혹0.01),신조직병이학손상감경o RL조、RM조화RH조수서분태니제량증가,혈청BUN화Cr농도、신조직MDA함량축점강저,SOD화Ca2+-ATP매활성축점승고(P＜0.05혹0.01),신조직병이학손상축점감경.결론 서분태니가감경대서신장결혈재관주손상,차여제량유관,기궤제여억제지질과양화반응、제고Ca2+-ATP매활성유관.
Objective To investigate the effects of different doses of remifentanil on the renal ischemiareperfusion (I/R) injury in rats. Methods Sixty male SD rats weighing 220-250 g were randomly divided into 5 groups ( n = 12 each): sham operation group (group S), model group (group M), low, median and high doses of remifentanil groups (RL, RM and RH groups). The rats were anesthetized with intraperitoneal 5% chloral hydrate 6 ml/kg. Renal ischemia was induced by clamping the bilateral renal arteries for 45 min using an atraumatwere infused via the caudal vein 15 min before ischemia respectively and the infusion was stopped at 30 min of reperfusion, while S and M groups received equal volume of normal saline instead. Blood samples were collected from the femoral vein at 30 min and 24 h of reperfusion for measurement of serum creatinine (Cr) and blood urea nitrogen (BUN) concentrations. The rats were sacrificed at 24 h of reperfusion and the renal tissues were removed for determination of MDA content, SOD and Ca2+ -ATPase activities. Pathological changes in renal tissues were observed with light and electron microscopes. Results Compared with group S, the concentrations of serum Cr and BUN and content of MDA were significantly increased, while activities of SOD and Ca2+ -ATPase were significantly decreased in the other 4 groups ( P ＜ 0.05 or 0.01). Compared with group M, the concentrations of serum Cr and BUN and content of MDA were significantly decreased, activities of SOD and Ca2+ -ATPase were significantly increased (P ＜0.05 or 0.01) and the pathological changes were reduced in RH, RM and RL groups. The plasma BUN and Cr concentrations and MDA content were decreased gradually and SOD and Ca2+ -ATPase activities were increased gradually with the increase in the doses of remifentanil in RL, RM and RH groups ( P ＜ 0.05 or 0.01 ).Remifentanil infusion significantly attenuated the pathologic changes in a dose-dependent manner. Conclusion Remifentanil can reduce the renal I/R injury in a dose-dependent manner by inhibiting lipid peroxidation and increasing Ca2+ -ATPase activity.