CAJ | 학술논문

目的评价瑞芬太尼对大鼠肾缺血再灌注时细胞凋亡的影响.方法健康成年雄性SD大鼠75只,体重220～ 250 g,采用随机数字表法,将其分为3组(n=25)∶假手术组(S组)、肾缺血再灌注组(I/R组)和瑞芬太尼组(R组).I/R组和R组采用夹闭双侧肾动脉45 min时恢复灌注法建立肾缺血再灌注损伤模型.R组于缺血前15 min至再灌注30 min经尾静脉输注瑞芬太尼1.0μg· kg-1·min-1,S组和I/R组给予等容量生理盐水.于缺血前15 min(T0)、再灌注3 h(T1)、6 h(T2)、12h(T3)及24 h(T4)时取肾组织标本.采用流式细胞术检测肾细胞凋亡率及Bax、Bcl-2蛋白表达,采用RT-PCR检测Bax和Bcl-2的mRNA表达,计算Bcl-2/Bax蛋白及mRNA表达比值,采用Paller法行肾小管损伤评分.结果与S组比较,I/R组和R组T1-4时肾小管损伤评分和肾细胞凋亡率升高,Bcl-2/Bax蛋白及mRNA表达比值T12时升高,T3,4时降低(P＜0.01)；与I/R组比较,R组T1-4时肾小管损伤评分和肾细胞凋亡率降低,Bcl-2/Bax蛋白及mRNA表达比值升高(P＜0.05或0.01)；与T0时比较,I/R组和R组T1-4时肾小管损伤评分和肾细胞凋亡率升高,Bcl-2/Bax蛋白及mRNA表达比值T1,2时升高,T3,4时降低(P＜0.01).结论瑞芬太尼减轻大鼠肾缺血再灌注损伤的机制与其调节Bcl-2/Bax蛋白表达,抑制肾组织细胞凋亡有关.
목적 평개서분태니대대서신결혈재관주시세포조망적영향.방법 건강성년웅성SD대서75지,체중220～ 250 g,채용수궤수자표법,장기분위3조(n=25)∶가수술조(S조)、신결혈재관주조(I/R조)화서분태니조(R조).I/R조화R조채용협폐쌍측신동맥45 min시회복관주법건립신결혈재관주손상모형.R조우결혈전15 min지재관주30 min경미정맥수주서분태니1.0μg· kg-1·min-1,S조화I/R조급여등용량생리염수.우결혈전15 min(T0)、재관주3 h(T1)、6 h(T2)、12h(T3)급24 h(T4)시취신조직표본.채용류식세포술검측신세포조망솔급Bax、Bcl-2단백표체,채용RT-PCR검측Bax화Bcl-2적mRNA표체,계산Bcl-2/Bax단백급mRNA표체비치,채용Paller법행신소관손상평분.결과 여S조비교,I/R조화R조T1-4시신소관손상평분화신세포조망솔승고,Bcl-2/Bax단백급mRNA표체비치T12시승고,T3,4시강저(P＜0.01)；여I/R조비교,R조T1-4시신소관손상평분화신세포조망솔강저,Bcl-2/Bax단백급mRNA표체비치승고(P＜0.05혹0.01)；여T0시비교,I/R조화R조T1-4시신소관손상평분화신세포조망솔승고,Bcl-2/Bax단백급mRNA표체비치T1,2시승고,T3,4시강저(P＜0.01).결론 서분태니감경대서신결혈재관주손상적궤제여기조절Bcl-2/Bax단백표체,억제신조직세포조망유관.
Objective To evaluate the effect of remifentanil on cell apoptosis during renal ischemia-reperfusion (I/R) in rats.Methods Seventy-five male Sprague-Dawley rats,weighing 220-250 g,were randomly divided into 3 groups (n =25 each):sham operation group (group S),I/R group,and remifentanil group (group R).Renal ischemia was induced by occlusion of the bilateral renal arteries for 45 min followed by reperfusion in groups I/R and R.Remifentanil was infused at 1.0 μg· kg-1 · min-1 via the caudal vein starting from 15 min before ischemia until 30 min of reperfusion in group R,while the equal volume of normal saline was given instead of remifentanil in groups S and I/R.At 15 min before ischemia (T0) and 3,6,12,24 h of reperfusion (T1-4),5rats were anesthetized and sacrificed,and renal specimens were obtained to detect the apoptotic rate and expression of Bax and Bcl-2 protein (by flow cytometry) and mRNA (by RT-PCR).The ratios between Bcl-2/Bax protein and mRNA expression were calculated.The pathological changes of renal tubules were scored.Results Compared with group S,the pathological scores and apoptotic rate were significantly increased at T1-4,and ratios between Bcl-2/Bax protein and mRNA expression were increased at T1,2,while decreased at T3,4 in groups R and I/R (P ＜0.01).Compared with group I/R,the pathological scores and apoptotic rate were significantly decreased at T1-4,while the ratios between Bcl-2/Bax protein and mRNA expression were increased in group R (P ＜ 0.05 or 0.01).Compared with the baseline value at T0,the pathological scores and apoptotic rates were significantly increased at T1 4,and the ratios of Bcl-2/Bax protein and mRNA expression were increased at T1,2,while decreased at T3,4 in groups R and I/R (P ＜ 0.01).Conclusion Regulation of Bcl-2/Bax expression and inhibition of cell apoptosis in renal tissues are involved in the mechanism by which remifentanil reduces renal I/R injury in rats.