CAJ | 학술논문

目的探讨瑞芬太尼预先给药对失血性休克兔急性肝损伤的影响.方法新西兰白兔32只,体重2.0～2.5 kg,雌雄不拘,采用随机数字表法,将兔随机分为4组(n=8):假手术组(S组)、失血性休克组(HS组)、瑞芬太尼低剂量组(RL组)、瑞芬太尼高剂量组(RH组).RL组和RH组分别静脉输注瑞芬太尼0.66、1.32 μg·kg-1·min-1 145 min,S组静脉输注等容量生理盐水.持续输注生理盐水或瑞芬太尼15 min后,经左侧股动脉以2～3 m1·kg-1·min-1速率缓慢放血,约10 min使MAP降至40mm Hg,通过放血、补液和输血维持MAP 35 ～ 45 mm Hg,持续120 min,制备失血性休克模型.于给药前(T0)、放血前即刻(T1)、放血10 min(T2)、放血后30 min(T3)、60 rmin(T4)、90 min(T5)、120 min(T6)时测定血清ALT、AST的活性;于T6时取血样后处死动物取肝组织观察病理学结果.结果与S组比较,其余3组T5、T6时血清ALT活性、T4～T6时血清AST活性升高(P＜0.05);与HS组比较,RH组T5、T6时血清ALT活性、T4～T6时血清AST活性降低(P＜0.05),RL组差异无统计学意义(P＞0.05);与RL组比较,RH组T5、T6时血清ALT活性、T4～T6时血清AST活性降低(P＜0.05);与T0时比较,3组T5、T6时血清ALT活性、T4～T6时血清AST活性升高(P＜0.05或0.01).RH组肝组织病理学损伤较HS组和RH组减轻.结论瑞芬太尼预先给药可减轻失血性休克兔急性肝损伤,且该作用与剂量有关.
목적 탐토서분태니예선급약대실혈성휴극토급성간손상적영향.방법 신서란백토32지,체중2.0～2.5 kg,자웅불구,채용수궤수자표법,장토수궤분위4조(n=8):가수술조(S조)、실혈성휴극조(HS조)、서분태니저제량조(RL조)、서분태니고제량조(RH조).RL조화RH조분별정맥수주서분태니0.66、1.32 μg·kg-1·min-1 145 min,S조정맥수주등용량생리염수.지속수주생리염수혹서분태니15 min후,경좌측고동맥이2～3 m1·kg-1·min-1속솔완만방혈,약10 min사MAP강지40mm Hg,통과방혈、보액화수혈유지MAP 35 ～ 45 mm Hg,지속120 min,제비실혈성휴극모형.우급약전(T0)、방혈전즉각(T1)、방혈10 min(T2)、방혈후30 min(T3)、60 rmin(T4)、90 min(T5)、120 min(T6)시측정혈청ALT、AST적활성;우T6시취혈양후처사동물취간조직관찰병이학결과.결과 여S조비교,기여3조T5、T6시혈청ALT활성、T4～T6시혈청AST활성승고(P＜0.05);여HS조비교,RH조T5、T6시혈청ALT활성、T4～T6시혈청AST활성강저(P＜0.05),RL조차이무통계학의의(P＞0.05);여RL조비교,RH조T5、T6시혈청ALT활성、T4～T6시혈청AST활성강저(P＜0.05);여T0시비교,3조T5、T6시혈청ALT활성、T4～T6시혈청AST활성승고(P＜0.05혹0.01).RH조간조직병이학손상교HS조화RH조감경.결론 서분태니예선급약가감경실혈성휴극토급성간손상,차해작용여제량유관.
Objective To investigate the effects of pretreatment with remifentanil on hemorrhagic shock (HS)-induced acute liver injury in rabbits.Methods Thirty-two New Zealand white rabbits,weighing 2.0-2.5 kg,were randomly divided into 4 groups (n=8 each): sham operation group (group S) ; group HS,low-dose remifentanil group (group RL) ; high-dose remifentanil group (group RH).Remifentanil was infused at 0.66 and 1.32 μg· kg-1 · min-1 for 145 min in groups RL and RH respectively,while the equal volume of normal saline was infused in group C.HS was induced by withdrawing blood from the left femoral artery at 15 min after continuous infusion of normal saline or remifentanil and mean arterial pressure (MAP) was reduced to 40 mm Hg.MAP was reduced to 35-45 mm Hg and maintained at this level for 120 min in groups HS,RL and RH.Blood samples were taken for determination of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities before administration (T0),immediately before blood letting (T1),and at 10,30,60 and 90 min after blood letting (T3-6).The animals were then sacrificed and the livers were immediately removed for microscopic examination.Results Compared with group S,the serum ALT activity at T5 and T6 and serum AST activity at T4-T6 were significantly increased in the other three groups (P ＜ 0.05).Compared with group HS,the serum ALT activity at T5 and T6,and serum AST activity at T4-T6 were significantly decreased in group RH,and no significant change was found in group RL (P ＞ 0.05).Compared with group RL,the serum ALT activity at T5 and T6,and serum AST activity at T4-T6 were significantly decreased in group RH (P ＜ 0.05).The serum ALT activity at T5 and T6 and serum AST activity at T4-T6 were significantly increased in groups HS,R and RH than those at T0 (P ＜ 0.05 or 0.01).The patho1ogical injury was attenuated in group RH compared with groups HS and RL.Conclusion Remifentanil pretreatment can attenuate HS-induced acute liver injury in rabbits,and the effect is related to the dose.