CAJ | 학술논문

目的研究脂肪乳(LE)对局部麻醉药(局麻药,丁哌卡因、罗哌卡因)导致大鼠心脏毒性的影响及其可能机制.方法选取SD大鼠54只,采用随机数字表法将其分为五组,生理盐水对照组(CON组)、生理盐水加丁哌卡因组(NS+B组)、脂肪乳加丁哌卡因组(LE+B 组)、生理盐水加罗哌卡因组(NS+R 组)、脂肪乳加罗哌卡因组(LE+R 组).除CON组外,其余组别再分为2个亚组,即致死组(1组)及取材组(2组).54只大鼠均分入CON组及每个亚组,每组6只.CON 组经静脉泵入NS 3 mL/(kg·min),6 min 后开胸取心;其余组静脉泵入 NS 或 LE 3 mL/(kg·min),共 5 min,再以2 mg/(kg·min)泵入相应局麻药,取材组(2组)泵入局麻药1 min开胸取心,致死组(1组)泵入局麻药至心搏骤停.记录大鼠心律失常、心搏骤停的时间及局麻药剂量,测定心肌Na+-K+-ATPase、Ca2+-Mg2+-ATPase及琥珀酸脱氢酶(SDH)的活性.结果与NS+B1组比较,LE+B1组大鼠出现心律失常和心搏骤停的时间明显延迟,所用丁哌卡因累积剂量显著增加,差异均有统计学意义(P<0.05);与NS+R1组比较,LE+R1组大鼠出现心律失常和心搏骤停的时间明显延迟,所用罗哌卡因累积剂量显著增加,差异均有统计学意义(P<0.05);CON组Na+-K+-ATPase、Ca2+-Mg2+-ATPase及SDH的活性最高,LE+B2组高于NS+B2组,LE+R2组高于NS+R2组,LE+R2组高于NS+B2组,差异均有统计学意义(P<0.05).结论 LE预处理能减轻丁哌卡因、罗哌卡因对大鼠心肌的毒性反应,其机制可能与增加心肌能量代谢水平有关.
목적 연구지방유(LE)대국부마취약(국마약,정고잡인、라고잡인)도치대서심장독성적영향급기가능궤제.방법 선취SD대서54지,채용수궤수자표법장기분위오조,생리염수대조조(CON조)、생리염수가정고잡인조(NS+B조)、지방유가정고잡인조(LE+B 조)、생리염수가라고잡인조(NS+R 조)、지방유가라고잡인조(LE+R 조).제CON조외,기여조별재분위2개아조,즉치사조(1조)급취재조(2조).54지대서균분입CON조급매개아조,매조6지.CON 조경정맥빙입NS 3 mL/(kg·min),6 min 후개흉취심;기여조정맥빙입 NS 혹 LE 3 mL/(kg·min),공 5 min,재이2 mg/(kg·min)빙입상응국마약,취재조(2조)빙입국마약1 min개흉취심,치사조(1조)빙입국마약지심박취정.기록대서심률실상、심박취정적시간급국마약제량,측정심기Na+-K+-ATPase、Ca2+-Mg2+-ATPase급호박산탈경매(SDH)적활성.결과 여NS+B1조비교,LE+B1조대서출현심률실상화심박취정적시간명현연지,소용정고잡인루적제량현저증가,차이균유통계학의의(P<0.05);여NS+R1조비교,LE+R1조대서출현심률실상화심박취정적시간명현연지,소용라고잡인루적제량현저증가,차이균유통계학의의(P<0.05);CON조Na+-K+-ATPase、Ca2+-Mg2+-ATPase급SDH적활성최고,LE+B2조고우NS+B2조,LE+R2조고우NS+R2조,LE+R2조고우NS+B2조,차이균유통계학의의(P<0.05).결론 LE예처리능감경정고잡인、라고잡인대대서심기적독성반응,기궤제가능여증가심기능량대사수평유관.
Objective To investigate the effect of lipid emulsion (LE) pretreatment on cardiotoxicity of SD rats caused by local anesthetics of marcaine and ropivacaine and to explore its possible mechanism. Methods 54 SD adult rats were selected and randomly divided into five groups,normal saline(NS) control group(group CON),NS+bupivacaine group(group NS+B),LE+bupivacaine group (group LE+B),NS+ropivacaine group (group NS+R) and LE+ropivacaine group (group LE+R). Except for the group CON,other groups were re-divided into two sub-groups:death group(group 1) and material group(group 2),6 cases in each group and subgroup. The group CON was pumped by NS 3 mL/(kg·min) via vein,and the heart was removed after 6 min. Other groups were intravenously pumped by NS or LE 3 mL/(kg·min) for 5 min,then pumped by local anesthetic 2 mg/(kg·min). In the material groups(2 groups),the hearts were removed after 1 min of local anesthetics pumping. The death group (1 group) was pumped by local anesthetic until cardiac arrest. The time of arrhythmia ,cardiac arrest and amount of local anesthetics were recorded. The activities of Na+-K+-ATPase,Ca2+-Mg2+-ATPase and succinate dehydrogenase(SDH) were measured. Results Com-pared with the group NS+B1,the time of arrhythmia and cardiac arrest appearance in the group LE+B1 were remarkably pro-longed(P<0.05) and the accumulated amount of marcaine was obviously increased,the differences were statistically significant (P<0.05). Compared with the group NS+R1,the time of arrhythmia and cardiac arrest appearance in the group LE+R1 were sig-nificantly prolonged(P<0.05) and the accumulated amount of ropivacaine were remarkably increased,the differences were statisti-cally significant(P<0.05);the activities of Na+-K+-ATPase,Ca2+-Mg2+-ATPase and SDH were highest in the group CON(P<0.05), and the group LE+B2 was higher than the group NS+B2 ,the group LE+R2 was higher than the group NS+R2 and the group LE+R2 was higher than the group NS+B2,the differences were statistically significant(P<0.05). Conclusion LE pretreatment can reduce the cardiac toxicity of marcaine and ropivacaine on SD rats and its mechanism is possibly related with the level of cardiac energy metabolism.