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目的观察不同浓度瑞芬太尼后处理对肾脏缺血再灌注大鼠心肌损伤的影响。方法建立大鼠肾脏缺血45min再灌注模型。SD大鼠40只随机分为5组,假手术组(sham组)、肾缺血再灌注组(I/R组)、瑞芬太尼后处理组(RF组),按照瑞芬太尼的不同浓度1μg.kg-1.min-1、2μg.kg-1.min-1、4μg.kg-1.min-1又分三个亚组:RF1、RF2、RF4组,术中通过四道生理记录仪观察再灌注60min和120min左室收缩压(LVSP)、左室舒张末压(LVEDP)的动态变化情况,实验结束后处死大鼠,光镜观察心肌组织形态学改变,测定心肌新鲜组织超氧化物歧化酶(SOD)活性、丙二醛(MDA)的含量、肌酸激酶同工酶(CK-MB)值。结果肾脏缺血再灌注大鼠的心肌功能受到明显的影响,I/R组大鼠的LVSP明显降低,LVEDP明显升高,瑞芬太尼后处理组上述指标的异常变化均能得到改善。光镜下可见I/R组呈明显心肌损伤的形态学变化,RF组心肌组织损伤明显改善。I/R、RF组心肌组织SOD活性较sham组下降,但是I/R组低于RF组(P<0.05)。I/R组的MDA含量、CK-MB值明显高于Sham组,但低于RF组。结论瑞芬太尼后处理对肾脏缺血再灌注大鼠心肌损伤具有一定程度的保护作用。
Objective To observe the effects of remifentanil at different concentrations on the myocardial injury induced by renal ischemia-reperfusion in rats. Methods The model of renal ischemia reperfusion 45min was established. Forty SD rats were randomly divided into 5 groups: sham group, I / R group, remifentanil postconditioning group (RF group), remifentanil Different concentrations of 1μg.kg-1.min-1, 2μg.kg-1.min-1, 4μg.kg-1.min-1 is divided into three subgroups: RF1, RF2, RF4 group, The changes of left ventricular systolic pressure (LVSP) and left ventricular end-diastolic pressure (LVEDP) at 60min and 120min after reperfusion were observed by physiological recorder. After the experiment, the rats were sacrificed and the changes of myocardial morphology were observed under light microscope. The activity of superoxide dismutase (SOD), content of malondialdehyde (MDA) and creatine kinase (CK-MB) were measured. Results Myocardial function was significantly affected by renal ischemia / reperfusion in rats. LVSP in I / R group was significantly decreased and LVEDP was significantly increased. Abnormal changes of these indices in remifentanil postconditioning group were all improved. Light microscope showed I / R group showed obvious morphological changes of myocardial injury, myocardial injury in RF group significantly improved. Compared with sham group, the activity of SOD in myocardium of I / R and RF group decreased, but the I / R group was lower than that of RF group (P <0.05). The contents of MDA and CK-MB in I / R group were significantly higher than those in Sham group but lower than those in RF group. Conclusion Remifentanil postconditioning has a protective effect on myocardial injury induced by renal ischemia-reperfusion in rats.