异氟醚预处理对兔心肌缺血再灌注损伤的保护作用及机制 _医学论文.docVIP

异氟醚预处理对兔心肌缺血再灌注损伤的保护作用及机制 _医学论文 异氟醚预处理对兔心肌缺血再灌注损伤的保护作用及机制 _医学论文 作者：姚立农 柴 伟 赵 晖 杨永慧 【关键词】 异氟醚 关键词: 异氟醚线粒体K+ ATP 通道预处理 摘 要:目的 　　探讨麻醉药异氟醚预处理对兔心缺血再灌注损伤的保护作用及机制. 方法 将兔40只造成在体局部心肌缺血再灌注模型，随机分成4组（n=10）.对照组无预处理5-HD组在缺血前40min给予5-HD5mg kg-1 异氟醚预处理组给予10mL L-1 异氟醚（呼气末）15min.异氟醚+5-HD组以上述方法同时给予异氟醚和5-HD.实验中持续监测左室收缩压（LVSP）、左室舒张末压（LVEDP）、左室内收缩压最大上升速率（+dp/dtmax ）和心率（HR）的变化，再灌注结束后用伊文蓝和TTC染色法确定缺血和梗死心肌范围. 结果 与对照组和5-HD组比较，缺血前异氟醚降低LVSP和+dp/dtmax （0.05），再灌注期各组血流动力学参数无明显差异.各组梗死范围占左室质量的百分数分别是（18±6）%，（20±9）%，（7±4）%和（17±4）%，与其余3组比较异氟醚预处理显著降低缺血心肌的梗死范围（0.05）.对照组、5-HD组和异氟醚+5-HD组无统计差异（Pgt0.05）. 结论 异氟醚预处理对兔心肌缺血再灌注损伤有明显的保护作用，其机制可能与线粒体K+ ATP 通道有关. 　　Keywords:isofluranemitochondrial K+ ATP preconditioning 　　Abstract:AIM To investigate the protective effects and the mechanisms of isoflurane induced preconditioning on ische-mia-reperfusion injury in rabbit hearts.METHODS Forty　rabbits were modelled as the reperfusion injury of ischemic myocardium and randomly divided into4groups.The control group received no pretreatment.5-hydroxydecanoate（5-HD）group was given only5mg kg-1 5-HD40min before ischemia.Isoflurane-preconditioned group was pretreated with end-tidal10mL L-1 isoflurane15min.Isoflurane plus5-HD group received5-HD10min before isoflurane.The LVSP，+dp/dtmax ，LVEDP and heart rate（HR）were recorded during the experiment.At the end of the reperfu-sion，infarct size and area at risk were defined by TTC stain┐ing.RESULTS Isoflurane decreased LVSP and+dp/dtmax compared with the control and5-HD groups（0.05）be-fore ischemia，but there was no significant difference between the four groups during the reperfusion.Isoflurane significant-ly reduced myocardial infarct size in the isoflurane group com-pared with the control，5-HD and isoflurane+5-HD groups（0.05）.The infarct size were（7±4）%，（18±6）%，（20±9）%，and（17±4）%respectively.There was no difference between the latter three groups（Pgt0.05）.CONCLUSION Isoflurane-induced preconditioning provides significant my-ocardial protection against ischima-reperfusio