本文關鍵詞： 布托啡諾 盲腸接扎法 膿毒血癥 心肌標志物　出處：《江西醫(yī)藥》2017年11期 　論文類型：期刊論文

【摘要】：目的探討布托啡諾在膿毒血癥中對心肌細胞的影響及其可能機制,為臨床尋找膿毒血癥中心肌損傷保護的可行方法提供依據(jù)。方法健康雄性SD大鼠(由南昌大學試驗動物科學部提供)81只,12-15周齡,隨機分為3組。采用隨機、陽性對照的試驗設計方法,本臨床研究的試驗組和對照組,按1:1:1的比例分配。按照統(tǒng)計學的最低要求,每組有效病例27例,分假手術組(A)、膿毒癥組(B)、布托啡諾+膿毒癥組(C),共81例,A、B、C組,A組緩慢靜脈推注生理鹽水5ml/kg,B組和C組經(jīng)股靜脈緩慢靜脈推注布托啡諾50μg/kg。B組和C組采用盲腸結(jié)扎穿孔法制備膿毒癥模型。術前進食12h,自由飲水,腹腔注射2%戊巴比妥鈉50mg/kg麻醉下,仰臥位固定,腹部備皮消毒,沿腹部正中線縱行作一長約1.5cm切口,分離腸細膜及盲腸,輕輕擠壓升結(jié)腸,使腸內(nèi)容物充滿盲腸,以3.0絲線于回盲部下方環(huán)形結(jié)扎盲腸根部。用20G穿刺針貫穿已結(jié)扎端2次,自穿刺孔擠出腸內(nèi)容物入腹腔,放置一長約2cm橡皮引流條,防止針孔閉合,然后將腸管還納腹腔,逐層縫合腹部切口,碘伏消毒切口。A組僅暴露盲腸;選擇24h為時間觀察點,模型復制后24h經(jīng)腹主動脈采血3ml,離心后取上清液-7℃保存?zhèn)溆?測定血清CK-MB及c Tn I,采用酶聯(lián)免疫吸附法(EI ISA)(試劑盒購自美國雅培公司)。其余心肌組織勻漿后取上清液,用放射免疫法測定ET-1(試劑盒購自上海研域化學試劑有限公司),采用ELISA法檢測TN-a(試劑盒由上海信然生物技術有限公司提供)。結(jié)果膿毒血癥組與假手術組的CK-MB、c Tn I濃度比較,其顯著升高(P0.01),差異有統(tǒng)計學意義,布托啡諾+膿毒癥組與膿毒血癥組CK-MB、c Tn I比較亦具有統(tǒng)計學意義(P0.05)。膿毒血癥組TNF-a和ET-1比假手術組要明顯升高,有極其明顯的顯著性差異(P值均0.01)。與膿毒血癥組相比,布托啡諾+膿毒癥組的TNF-a和ET-1明顯下降,差異也具有統(tǒng)計學意義(P值均0.05)。結(jié)論布托啡諾注射液能減輕膿毒癥大鼠的心肌損傷。
[Abstract]:Objective to investigate the effect of butorphanol on cardiomyocytes in sepsis and its possible mechanism. Methods healthy male Sprague-Dawley rats (81 male Sprague-Dawley rats aged 12-15 weeks provided by the Department of Experimental Animal Science of Nanchang University) were randomly divided into 3 groups. The design method of the positive control trial, the experimental group and the control group in this clinical study were divided according to the ratio of 1: 1 to 1: 1. According to the minimum statistical requirements, 27 effective cases were found in each group. The patients were divided into sham-operated group, septic group, butorphanol sepsis group and butorphanol sepsis group. 81 patients were treated with cecal ligation and perforation by cecal ligation in group A (5 ml / kg) via femoral vein and group C (group C) by slow intravenous injection of butorphanol (50 渭 g / kg 路kg 路B) via femoral vein. The model of sepsis was established by preoperation. Eating for 12 hours before operation and drinking freely. Under intraperitoneal injection of 2% pentobarbital sodium 50 mg / kg anesthesia, supine position was fixed, abdominal skin was disinfected, a 1.5 cm long incision was made along the median line of abdomen, the thin film of intestine and cecum were separated, and the ascending colon was pressed gently, so that the intestinal contents were filled with cecum. The root of the caecum was ligated with 3.0 silk thread in a circular way under the ileocecal part. The intestinal contents were extruded from the puncture hole into the abdominal cavity twice with a 20G puncture needle, and a rubber drainage strip of about 2 cm was placed to prevent the closure of the pinhole, and then the intestinal tube was returned to the abdominal cavity. The abdominal incision was sutured layer by layer, and the caecum was only exposed in group A. 24 hours after the model was duplicated, the blood was collected from abdominal aorta at 3ml, then the supernatant was taken for preservation at -7 鈩，

本文編號：1540105