丙泊酚预处理对兔缺血再灌注心肌的保护作用

目的 观察丙泊酚预处理对兔心肌缺血再灌注损伤（MIRI）心肌的保护作用.方法 实验用新西兰雄性大白兔40只,随机分为4组（n=10）：假手术组（Sham组）、缺血再灌注组（IR组）、缺血预处理组（IP组）和丙泊酚预处理组（PP组）.采用高效液相色谱（HPLC）法测定心肌组织中高能磷酸化合物三磷酸腺苷（ATP）、二磷酸腺苷（ADP）和一磷酸腺苷（AMP）的含量,检测心肌组织超氧化物歧化酶（SOD）、丙二醛（MDA）和血清乳酸脱氢酶（LDH）及肌酸激酶同功酶（CK-MB）活性.结果 IP组和PP组较IR组ATP、ADP和AMP含量明显增加,SOD活性增高,MDA生成量下降,LDH、CK-MB含量明显降低（P＜0.05或P＜0.01）.而IP组与PP组比较,各指标差异无统计学意义（P＞0.05）.结论 丙泊酚预处理同缺血预处理一样对缺血再灌注损伤心肌具有明显的保护作用,其作用机制可能与其改善心肌细胞能量代谢,降低心肌酶活性和氧自由基水平,拮抗脂质过氧化物反应有关.

Protective effects of propofol pretreatment on ischemia-reperfusion injury in rabbit heart

Objective To study the protective effects of propofol pretreatment on ischemia-reperfusion injury in rabbit heart. Methods Forty New Zealand white rabbits (40 male, weighting 2. 5 ± 0. 36kg) were randomly assigned to 4 groups, including sham operation group, ischemia reperfusion (IR)group, IR + ischemia preconditioning (IP) group and IR + Propofol preconditioning (PP) group (n =10 each). The myocardial ischemia-reperfusion model of rabbits was established by coronary artery ligation.The levels of high energy phosphates (ATP, ADP and AMP) in myocardial tissue were measured by HPLC.The activities of serum lactate dehydrogenase (LDH), serum creatine kinase-MB (CK-MB) superoxide dismutase (SOD) and malondiadehyd (MDA) in myocardial tissue were assayed. Results The content of ATP, ADP, AMP, and the activity of SOD in PP group and IP group were higher than that of IR group, and the content of LDH, MDA and CK-MB in injured myocardial tissue in PP group and IP group were obviously lower than that of IR group (P ＜0. 05, P ＜0. 01). No difference was found in PP group and IP group(P＞0. 05). Conclusion Propofol preconditioning as well as ischemia preconditioning protected the myocardial tissues from the ischemia-reperfusion injury by improving the myocardial energy metabolism, the debasement of the oxyradical level and the antagonism the reaction of lipid peroxides.