CAJ | 학술논문

目的：：观察腹主动脉内灌注 Mu 阿片受体(MOR)激动剂瑞芬太尼聚己内酯(REM-PCL)对脊髓缺血再灌注损伤(SCIRI)兔体感诱发电位(SEP)的影响。方法：30只健康新西兰大白兔随机分为对照组、R 组和 RG 组,每组10只。 R 组和 RG 组采用肾下腹主动脉阻断法制备 SCIRI 模型,于阻断血流时经腹主动脉局部灌注 REM-PCL 0.1 mg/ kg,RG 组于 REM-PCL 灌注结束后再局部灌注 MOR 拮抗剂 GSK1521498(1 mg/ kg),对照组局部灌注等容量生理盐水。分别于阻断前,再灌注15、30、60 min 及再灌注24 h 监测血清神经特异性烯醇化酶(NSE)质量浓度和SEP；再灌注6、12和24 h 进行神经行为学评分,然后于再灌注24 h 取脊髓组织检测 MOR mRNA 和感觉神经元异常率。结果：3组血清 NSE 质量浓度变化、SEP 变化、神经行为学评分、脊髓组织 MOR mRNA 表达水平和感觉神经元异常率差异均有统计学意义(P 均<0.05)。 RG 组上述指标测值及变化趋势与对照组相似(P >0.05)。与对照组和 RG 组比较,再灌注期间 R 组血清 NSE 质量浓度明显较低,SEP OL 延长程度较小,IPA 较快恢复,神经行为学评分较低；再灌注24 h 时,R 组脊髓组织 MOR mRNA 表达水平较高,感觉神经元异常率明显较低(P <0.05)。结论：腹主动脉内灌注 REM-PCL 可以通过激活 MOR,减轻脊髓电生理功能障碍。
목적：：관찰복주동맥내관주 Mu 아편수체(MOR)격동제서분태니취기내지(REM-PCL)대척수결혈재관주손상(SCIRI)토체감유발전위(SEP)적영향。방법：30지건강신서란대백토수궤분위대조조、R 조화 RG 조,매조10지。 R 조화 RG 조채용신하복주동맥조단법제비 SCIRI 모형,우조단혈류시경복주동맥국부관주 REM-PCL 0.1 mg/ kg,RG 조우 REM-PCL 관주결속후재국부관주 MOR 길항제 GSK1521498(1 mg/ kg),대조조국부관주등용량생리염수。분별우조단전,재관주15、30、60 min 급재관주24 h 감측혈청신경특이성희순화매(NSE)질량농도화SEP；재관주6、12화24 h 진행신경행위학평분,연후우재관주24 h 취척수조직검측 MOR mRNA 화감각신경원이상솔。결과：3조혈청 NSE 질량농도변화、SEP 변화、신경행위학평분、척수조직 MOR mRNA 표체수평화감각신경원이상솔차이균유통계학의의(P 균<0.05)。 RG 조상술지표측치급변화추세여대조조상사(P >0.05)。여대조조화 RG 조비교,재관주기간 R 조혈청 NSE 질량농도명현교저,SEP OL 연장정도교소,IPA 교쾌회복,신경행위학평분교저；재관주24 h 시,R 조척수조직 MOR mRNA 표체수평교고,감각신경원이상솔명현교저(P <0.05)。결론：복주동맥내관주 REM-PCL 가이통과격활 MOR,감경척수전생리공능장애。
Aim: To investigate the effect of Mu-opioid receptor(MOR) agonist remifentanil-poly-caprolactone(REM-PCL) on the somatosensory evoked potential(SEP) of rabbits with spinal cord ischemia reperfusion injury(SCIRI). Meth-ods: A total of 30 healthy rabbits were randomly allocated into control group, R group and RG group, 10 rabbits in each group. In group R and RG, the infrarenal abdominal aorta occlusion method was used to establish SCIRI model, and then REM-PCL was perfused at 0. 1 mg/ kg by abdominal aorta; RG group were given local perfusion of MOR antagonist GSK1521498(1 mg/ kg), and the rabbits in the control group were perfused with normal saline. Before occlusion, after reperfusion for 15, 30, 60 min and reperfusion for 24 h, the serum neuron specific enolase(NSE) concentration and SEP were monitored; after reperfusion for 6, 12 and 24 h, neurobehavioral score was assessed and MOR mRNA and sensory neurons abnormal rate in spinal cord tissue were detected. Results: The differences in serum NSE level, SEP changes, neurobehavioral score, MOR mRNA expression and sensory neurons abnormal rate among the 3 groups were statistically sig-nificant(P < 0. 05). The indexes mentioned above and the change trend of RG group were similar to those of the control group(P > 0. 05). Compared with the control group and RG group, during reperfusion, OL showed a lesser extent, IPA re-covered rapidly, the concentration of serum NSE and neurobehavioral scores were lower in R group;after reperfusion for 24 h, MOR mRNA expression in spinal cord tissue were higher, and sensory neuron abnormal rate was significantly lower(P <0. 05). Conclusion: REM-PCL perfusion in abdominal aorta could relieve spinal cord electrophysiological dysfunction by activating MOR.