摘要
目的 探讨异氟醚、七氟醚、地氟醚预处理对心肌缺血再灌注过程中心肌细胞凋亡的影响。方法 48只新西兰白兔随机分成6组（n=8）:假手术对照组P组）、心肌缺血再灌注对照组（IR组）、缺血预处理组（IP组）、异氟醚预处理组（I组）、七氟醚预处理组（S组）、地氟醚预处理组（D组）。除P组外,每组均接受左冠脉前降支3h阻断和3h再灌注。IP组在缺血前接受连续3次每次缺血5min、再灌注5min的预处理,吸入药预处理组在缺血前分别吸入1MAC的异氟醚、七氟醚或地氟醚30min后洗脱15min。取心肌缺血区边缘组织用琼脂糖电脉检测DNA梯带的形成,用流式细胞仪测凋亡指数（AI）。结果 心肌梗死范围占缺血范围的百分比及AI,IP、I、S及D组较IR组显著减少（P<0.05）。IR组DNA梯带的形成明显,IP、I、S、D组减弱、变模糊。结论 异氟醚、七氟醚、地氟醚预处理能抑制心肌缺血再灌注所致的心肌细胞凋亡。
Objective To investigate the effects of pretreatment with volatile anesthetics on myocardial apoptosis induced by myocardial ischemia-reperfusion. Methods Forty-eight healthy New Zealand white rabbits of both sexes weighing 3.2-3.5kg were anesthetized with intramuscular ketamine 70mg·kg-1. The animals were tracheotomized and intubated and mechanically ventilated. PaCO2 was maintained at 4-4.5kPa. Sternum was longitudinally splitted. Left anterior descending branch of coronary artery was exposed and mobilized and a fine rubber tube was placed around it for occlusion of the artery. The occlusion of the artery was confirmed by cynosis of the area of myocardium involved and ECG which showed elevation of S-T segment. The animals were randomly allocated to one of 6 groups of 8 animals in each group: sham-operation group (P) ; ischemia / preconditioning group (IP) ; and three groups pretreated with isoflurane (I), sevoflurane (S) and desflurane (D) . Each group except group P was subjected to 3h occlusion of left anterior descending artery followed by 3h reperfusion. Group I, S and D were pretreated with inhalation of 1.1% isoflurane, 2% sevoflurane or 6% desflurane for 30 min followed by 15 min washout. The heart was then removed after ischemia-reperfusion. Infarct size and ischemic area were determined by dual staining with triphenyltetrazolium chloride and Evan' s blue. DNA laddering in the border zone of myocardial ischemic area was revealed by agarose gel electrophoresis. Apoptosis index (A I ) was obtained by flow cytometry. Results The infarct size, expressed as the percentage of the ischemic area was (60.8±10.8)% in ischemia-reperfusion group and was greatly reduced in group IP (33.1 ±4.9)%, group I (39.0±5.9)%, group S (30.9 ±6.8)% and group D (32.2± 7.5)% (P<0.05). Apoptosis index was (13.83±3.98) % in ischemia-reperfusion group and was significantly reduced in group IP (5.85±1.59)%, group I (6.68±1.81) %, group S (6.67±1.57) % and group D (7.41±1.96)% (P<0.05) . DNA laddering was clearly demonstrated in ischemia-reperfusion group but attenuated ingroup IP, group I, group S and group D. Conclusion Pretreatment with isoflurane, sevoflurane or desflurane can inhibit myocardial apoptosis induced by myocardiol ischemia-reperfusion in rabbits.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2002年第8期483-485,共3页
Chinese Journal of Anesthesiology
基金
国家自然科学基金资助项目(3980013)
关键词
异氟烷
心肌再灌注损伤
脱噬作用
七氟醚
地氟醚
Isoflurane
Myocardial reperfusion injury
Apoptosis
Sevoflurane
Desflurane
