本文關(guān)鍵詞： 舒芬太尼 咪達(dá)唑侖 缺血-再灌注模型 心肌損傷 心肌梗死　出處：《臨床麻醉學(xué)雜志》2017年10期 　論文類型：期刊論文

【摘要】：目的探討舒芬太尼預(yù)處理聯(lián)合不同劑量咪達(dá)唑侖后處理對(duì)大鼠心肌缺血-再灌注(ischemia-reperfusion,IR)損傷的影響。方法 SPF級(jí)健康雄性SD大鼠42只,隨機(jī)分為七組,每組6只。A組:行假手術(shù),穿線不結(jié)扎;B0~B5組:構(gòu)建大鼠心肌IR模型,均結(jié)扎0.5h,再灌注2h。其中B0組:未經(jīng)舒芬太尼和/或咪達(dá)唑侖處理;B1組:經(jīng)舒芬太尼3μg/kg預(yù)處理;B2組:經(jīng)咪達(dá)唑侖0.1mg/kg后處理;B3組:經(jīng)咪達(dá)唑侖0.3mg/kg后處理;B4組:經(jīng)舒芬太尼1.5μg/kg預(yù)處理聯(lián)合咪達(dá)唑侖0.05mg/kg后處理;B5組:經(jīng)舒芬太尼1.5μg/kg預(yù)處理聯(lián)合咪達(dá)唑侖0.15mg/kg后處理。經(jīng)頸靜脈,舒芬太尼于缺血前注入,咪達(dá)唑侖于缺血后注入。心肌IR結(jié)束后測(cè)定血清肌酸激酶同工酶(CK-MB)、乳酸脫氫酶(LDH)、超氧化物歧化酶(SOD)活性和血清丙二醛(MDA)濃度,及炎性因子TNF-α和IL-6濃度。再灌注2h取各組大鼠心臟,測(cè)算心肌梗死嚴(yán)重程度(IS/AAR),采用Western blot法檢測(cè)心肌組織中Bcl-2、Bax及cleaved-caspase-3蛋白含量。結(jié)果B0~B5組CK-MB和LDH活性、MDA、TNF-α和IL-6濃度、Bax及cleaved-caspase 3蛋白含量均明顯高于A組(P0.05),B1~B5組均明顯低于B0組(P0.05),B3和B4組明顯低于B2組(P0.05),B5組明顯低于B1~B4組(P0.05);B1~B5組IS值及IS/AAR(%)值均明顯低于B0組(P0.05),B3和B4組明顯低于B2組(P0.05),B5組明顯低于B1~B4組(P0.05);B0~B5組SOD活性及Bcl-2含量均明顯低于A組(P0.05),B1~B5組均明顯高于B0組(P0.05),B3和B4組明顯高于B2組(P0.05),B5組明顯高于B1~B4組(P0.05)。與B0組比較,B5組CKMB、LDH活性明顯下降,SOD活性明顯上升,MDA、TNF-α、IL-6濃度明顯下降,IS/AAR明顯下降,Bcl-2含量增至B0組的2.25倍,Bax含量降至B0組的54.89%,cleaved-caspase-3含量降至B0組的49.67%。結(jié)論舒芬太尼預(yù)處理聯(lián)合咪達(dá)唑侖后處理可明顯減輕大鼠心肌IR損傷,對(duì)心肌的保護(hù)作用明顯優(yōu)于單獨(dú)使用時(shí)。
[Abstract]:Objective to investigate the effects of sufentanil preconditioning combined with different doses of midazolam postconditioning on myocardial ischemia-reperfusion reperfusion in rats. Methods 42 healthy male SD rats of SPF grade were randomly divided into seven groups: group A (n = 6): sham operation without ligation; Group B _ 0: rat myocardial IR model was established, all rats were ligated for 0.5 h and reperfusion for 2 h. Group B _ 0 was not treated with sufentanil and / or midazolam. Group B1 was pretreated with sufentanil 3 渭 g / kg; Group B2: 0.1 mg / kg after treatment with midazolam; Group B3: after treatment with midazolam 0.3 mg / kg; Group B4 was treated with sufentanil 1.5 渭 g / kg preconditioning combined with midazolam 0.05 mg / kg after treatment. Group B5 was pretreated with sufentanil 1.5 渭 g / kg and midazolam 0.15 mg / kg. Sufentanil was injected into jugular vein before ischemia. Midazolam was injected after ischemia. Serum creatine kinase isoenzyme (CK-MBN) and lactate dehydrogenase (LDH) were measured after IR. The activity of superoxide dismutase (SOD), the concentration of serum malondialdehyde (MDA), and the concentrations of inflammatory cytokines TNF- 偽 and IL-6 were collected at 2h after reperfusion. The severity of myocardial infarction was measured and Bcl-2 in myocardial tissue was detected by Western blot method. Results the activity of MDA-TNF- 偽 and IL-6 in CK-MB and LDH in group B _ 0 and B _ (5) were determined. The protein contents of Bax and cleaved-caspase 3 were significantly higher in group A than those in group A (P 0.05). Group B _ 3 and B _ 4 were significantly lower than group B _ 2 than group B _ 2 (P 0.05) and group B _ (5) were lower than group B _ (1) B _ (4). The values of is and IS-AARA in group B1 / B5 were significantly lower than those in group B0 (P 0.05) and group B 4 (P 0.05). Group B _ 5 was significantly lower than that of group B _ (1) B _ (4) (P 0.05). The activity of SOD and the content of Bcl-2 in group B _ (0) B _ (5) were significantly lower than those in group A (P _ (0.05) and B _ (1) B _ (1) B _ (5) were significantly higher than those in group B _ (0)). Group B _ 3 and B _ 4 were significantly higher than group B _ 2 than group B _ 2 (P 0.05) and group B _ (1) B _ (4) were significantly higher than group B _ (1) B _ (4) (P _ (0.05)). The activity of SOD was significantly increased. The concentration of TNF- 偽 IL-6 in MDA-TNF- 偽 decreased significantly. The content of Bcl-2 increased to 2.25 times of that of B0 group. The content of Bax decreased to 54.89% of group B0. Conclusion Sufentanil preconditioning combined with midazolam post-treatment can significantly reduce myocardial IR injury in rats. The protective effect on myocardium was obviously superior to that of using alone.
【作者單位】： 成都軍區(qū)總醫(yī)院麻醉科;
【基金】：2016軍隊(duì)后勤科研項(xiàng)目(CCD16J001)
【分類號(hào)】：R614
【正文快照】： Influences of sufentanil and midazolam coprocessing on myocardial injury in rats during myocardial is-chemia-reperfusion GONG Gu,CHEN Liang,DAI Xuemei,REN Ling,GU Xuedong,WU Wei.Department of Anesthesiology,General Hospital of Chengdu Military Region of

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