CAJ | 학술논문

目的：观察瑞芬太尼后处理对大鼠心肌缺血再灌注细胞凋亡的影响。方法建立60只大鼠心肌缺血再灌注损伤模型。随机分为假手术组（ sham组）、缺血再灌注对照组（ I-R组）和瑞芬太尼不同剂量后处理组（RPO1、RPO2、RPO3组），RPO1、RPO2、RPO3组再灌注之初分别以2、4、6μg／kg静脉泵注5 min，停止5 min，重复进行三次。实验结束后留取左室心肌组织标本，光镜下观察心肌组织的病理变化；用原位末端转移酶标记法（ TUNEL）检测各组心肌细胞的凋亡指数（AI）；用蛋白免疫印迹（Western blot）法检测各组心肌细胞色素C（CytC）含量。结果①光镜观察：RPO组大鼠的心肌组织损伤程度明显低于I-R组。②RPO组心肌细胞AI明显低于I-R组（P＜0．05），各RPO组之间心肌组织AI呈剂量依赖性（P＜0．05）。③RPO组心肌细胞胞浆中的CytC含量明显低于I-R组（ P＜0．05）。结论①瑞芬太尼后处理可以减轻大鼠心肌缺血再灌注损伤。②瑞芬太尼三种不同浓度后处理对减轻心肌组织损伤有明显的差别。③瑞芬太尼后处理减轻大鼠心肌缺血再灌注损伤的机制可能与抑制细胞凋亡有关。
목적：관찰서분태니후처리대대서심기결혈재관주세포조망적영향。방법건립60지대서심기결혈재관주손상모형。수궤분위가수술조（ sham조）、결혈재관주대조조（ I-R조）화서분태니불동제량후처리조（RPO1、RPO2、RPO3조），RPO1、RPO2、RPO3조재관주지초분별이2、4、6μg／kg정맥빙주5 min，정지5 min，중복진행삼차。실험결속후류취좌실심기조직표본，광경하관찰심기조직적병리변화；용원위말단전이매표기법（ TUNEL）검측각조심기세포적조망지수（AI）；용단백면역인적（Western blot）법검측각조심기세포색소C（CytC）함량。결과①광경관찰：RPO조대서적심기조직손상정도명현저우I-R조。②RPO조심기세포AI명현저우I-R조（P＜0．05），각RPO조지간심기조직AI정제량의뢰성（P＜0．05）。③RPO조심기세포포장중적CytC함량명현저우I-R조（ P＜0．05）。결론①서분태니후처리가이감경대서심기결혈재관주손상。②서분태니삼충불동농도후처리대감경심기조직손상유명현적차별。③서분태니후처리감경대서심기결혈재관주손상적궤제가능여억제세포조망유관。
Objective To study the effect of refentanil postcondition on cell apoptosis induced by myocardial ischemia and reperfusion in rats .Methods To build the myocardial ischemia and reperfusion injury model .The animals were randomly divided into three groups: sham operation group (sham, n=12);ischemia-reperfusion control group (I-R, n=12) and refentanil postconditioning group which was further divided into three subgroups according to the dose of refentanil ( RPO ) .In control group the hearts were subjected to 30 min ischemia followed by 90 min reperfusion ( I-R) .In RPO group the hearts were subjected to 30 min ischemia followed by 3 periods of 5 min refentanil infusion at 2 (RPO1,n=12), 4 (RPO2, n=12), 6 (RPO3, n=12) μg/kg at 5 min interval before reperfusion .Morphological change of the heart was observed by light microscopy .The apoptosis index ( AI) of cardiomyocyte was detected by TUNEL .The release of CytC protein was detected by Western blot.Results ①Light microscopy: myocardial injuries were lighter in refentanil postconditioning than those in intestinal ischemia -reperfusion group significantly .②Administration of refentanil postconditioning group exerted a significant anti-apoptotic effect, as evidenced by reduced TUNEL -positive staining .③Compared with Sham group , the expression of CytC protein in I -R and RPO group was significantly increased ( P<0.05);the expression of CytC protein in RPO group was lower than that in I-R group (P<0.05).Conclusion ①Refentanil postconditioning can protect myocardial injury induced by myocardial ischemia -reperfusion in rats .②The protect effect of refenanil is concentration dependent .③One of mechanisms of protection may be that refentanil decrease cell apoptosis .