CAJ | 학술논문

目的：观察山莨菪碱与芬太尼单用及两药联用对兔心肌缺血再灌注代谢指标的影响。方法日本大耳白兔48只，用结扎左冠状动脉前降支30 min、复灌120 min建立心肌缺血再灌注模型。随机分为6组（ n＝8）：假手术组（动脉下仅穿线不结扎）；缺血再灌注组（直接恢复再灌注）；缺血后适应组（缺血后适应后恢复再灌注）；芬太尼组、山莨菪碱组、联合用药组（缺血28 min，分别给予芬太尼5μg· kg-1、山莨菪碱5 mg· kg -1及芬太尼5μg· kg-1＋山莨菪碱5 mg· kg-1后处理），30 min予以缺血后适应后，恢复再灌注。检测各组血清代谢指标的浓度差异。结果山莨菪碱组与芬太尼组血清代谢指标比较差异无统计学意义；2个单用药组较联合用药组，缺血后适应组的外周血丙二醛浓度明显降低，超氧化物歧化酶活力浓度明显增高（ P＜0.01）。结论心肌缺血后适应与芬太尼及山莨菪碱后处理联合对再灌注损伤的保护作用显著大于两药单独作用。
목적：관찰산랑탕감여분태니단용급량약련용대토심기결혈재관주대사지표적영향。방법일본대이백토48지，용결찰좌관상동맥전강지30 min、복관120 min건립심기결혈재관주모형。수궤분위6조（ n＝8）：가수술조（동맥하부천선불결찰）；결혈재관주조（직접회복재관주）；결혈후괄응조（결혈후괄응후회복재관주）；분태니조、산랑탕감조、연합용약조（결혈28 min，분별급여분태니5μg· kg-1、산랑탕감5 mg· kg -1급분태니5μg· kg-1＋산랑탕감5 mg· kg-1후처리），30 min여이결혈후괄응후，회복재관주。검측각조혈청대사지표적농도차이。결과산랑탕감조여분태니조혈청대사지표비교차이무통계학의의；2개단용약조교연합용약조，결혈후괄응조적외주혈병이철농도명현강저，초양화물기화매활력농도명현증고（ P＜0.01）。결론심기결혈후괄응여분태니급산랑탕감후처리연합대재관주손상적보호작용현저대우량약단독작용。
Objective To explore the effect of the combination of aniso-damine and fentanyl on metabolic indicators , as well as the two drugs separately combined with myocardial ischemia post -processing against myocardial ischemia and reperfusion injury in rabbits.Methods The pre-ligated left anterior descending coronary artery ( LAD) for 30 min and 120 min of reperfusion were adopted to establish myocardial ischemia-reperfusion model.The 48 Japanese white rabbits were randomly as-signed to six groups ( n=8 each ): Sham-operated group ( group S ) , to separate LAD without ligation; ischemia -reperfusion group ( group I/R ) , to restore reperfusion directly; ischemic postconditioning group ( group IP C ) after 30 min′s ischemia , to give ischemic postconditioning and then to restore reperfusion; fentanyl postconditioning group ( group F), anisodamine postconditioning group ( group A), and a combination of fentanyl and anisodamine postconditioning group ( group F+A):ische-mia for 28 min, and then different doses were injected respectively through ear marginal vein as follows: 5 μg · kg -1 of fentanyl , 5 mg · kg -1 of anisodamine , and the two kind of drugs combined for pharmanic post-processing.After 30 min of ischemia , post conditioning was given and then reperfusion was restrored.Differences in the peripheral metabo-lism of superoxide dismutase ( SOD ) , and malondialdehyde ( MDA ) were detected.Results The group A and group F were equal in the concentration of MDA and the active concentration of SOD ( P>0.05 ) ,but for the concentration of MDA , group F+A was lower than these two groups and group IP C was higher than them.However , in terms of the active concentration of SOD, group F+A was higher than these two groups and group IP C was lower than them (P<0.01) .Conclusion Myocardial ischemic postconditioning combined with fentanyl and anisodamine for the treatment of myocardial reperfu -sion injury was much more effective than the single -drug combination with ischemic postconditioning.