腰椎旁神经阻滞联合全凭静脉全身麻醉对髋关节置换术患者血流动力学、应激反应、术后苏醒的影响

目的 观察腰椎旁神经阻滞联合全凭静脉全身麻醉对髋关节置换术患者血流动力学、应激反应、术后苏醒的影响.方法 选取2018年1月—2019年8月我院收治的行髋关节置换术患者115例,根据手术麻醉方法 的不同分为观察组60例和对照组55例,观察组予腰椎旁神经阻滞联合全凭静脉全身麻醉,对照组仅予全凭静脉全身麻醉.比较两组麻醉...     

β-胡萝卜素对去甲肾上腺素致大鼠心肌肥厚的保护作用

目的:研究β-胡萝卜素(BC)对去甲肾上腺素致大鼠心肌肥厚的保护作用。方法:去甲肾上腺素(NE)2mg/kg腹腔注射,每日2次,去甲肾上腺处理的大鼠给予BC 250 mg/(kg.d)灌胃进行干预,连续给药15 d。测定全心重量指数(HW/BW)、左心室重量指数(LVW/BW,即LVI);采用放免分析法检测左心室心肌组织中血管紧张素Ⅱ(AngⅡ)含量,用免疫组织化学方法检测左心室心肌组织中血管紧张素Ⅱ1型受体(AT1R)的表达,采用硫代巴比妥酸法测定丙二醛(MDA)含量,采用黄嘌呤氧化酶法测定超氧化物歧化酶(SOD)活性。结果:NE模型组大鼠的HW/BW、LVI明显升高;左心室心肌组织AngⅡ含量、AT1R表达增高,心肌和血清中MDA含量增高,SOD含量降低。β-胡萝卜素能通过抗氧化作用而明显降低心肌组织AngⅡ、MDA含量和AT1R的表达,提高SOD含量,使HW/BW及LVI下降,抑制心肌肥厚。结论:β-胡萝卜素对去甲肾上腺素所致心肌肥厚有保护作用。     

GABA-receptor stimulation enhances norepinephrine-induced polyphosphoinositide metabolism in rat hippocampal slices

The effect of gamma-aminobutyric acid (GABA)receptor stimulation on norepinephrine (NE)-induced metabolism of polyphosphoinositides (PIPs) was studied in rat hippocampal slices. Inositol phosphates (IPs), PIPs, and phosphatidic acid were measured. NE induced formation of IPs and phosphatidic acid in a dose-dependent manner with an EC50 of 4.5 microM. GABA, 3-aminopropanesulphonic acid (3APS) and muscimol did not affect PIPs breakdown, but they strongly increased (greater than 100%) PIPs metabolism induced by 1 microM NE. Their action was antagonized by bicuculline (10 microM). We discuss the implications of these findings in hippocampal neurotransmission.     

去甲肾上腺素对大鼠腹腔巨噬细胞内IP_3、［Ca~（2＋）］_i和Ia抗原表达

本文应用细胞膜放射标记和离子交换层析法测定巨噬细胞（ＭФ）内肌醇－１，４，５－三磷酸（ＩＰ３）、用Ｃａ￣（２＋）指示剂的分光光谱法测定ＭФ内Ｃａ￣（２＋）浓度（［Ｃａ￣（２＋）］）、用ＡＰＡＡＰ桥联酶标法检测ＭФ表面Ｉａ抗原的表达，研究去甲肾上腺素（ＮＥ）对大鼠腹腔的ＭФ内ＩＰ３、［Ｃａ￣（２＋）］ｉ和ＭФ表面ｌａ抗原表达的影响。结果显示ＮＥ（１０￣（－８）ｍｏｌ／Ｌ）可显著增高ＭФ中ＩＰ＿３含量（４４２±２２ｃｐｍ／１０￣６ｃｅｌｌｓ，对照组１０２±８ｃｐｍ／１０￣６ｃｅｌｌｓ，Ｐ＜０．０１）；ＮＥ可使ＭФ内［Ｃａ￣（２＋）］ｉ显著增高（３２２±７８ｎｍｏｌ／Ｌ，对照组９７±１７ｎｍｏｌ／Ｌ，Ｐ＜０．０１）；ＮＥ可显著增高ＭФ表面Ｉ－Ａ、Ｉ－Ｅ抗原的表达（６４±８％、５８±６％，对照组５０±３％，４４±４％，Ｐ＜０．０１）。提示神经递质ＮＥ促进ＭФ表面Ｉａ抗原表达的作用可能是通过第二信使ＩＰ＿３和Ｃａ￣（２＋）介导的。     

远端保护装置对急性心肌梗死患者神经内分泌的影响

目的 探讨急性ST段抬高性心肌梗死(STEMI)急诊经皮冠状动脉成形术(PCI)中应用远端保护装置对神经内分泌指标的影响及其临床价值.方法 本研究为前瞻性对照研究,将2004年9月至2006年12月在青岛市市立医院行急诊PCI的72例STEMI患者随机(随机数字法)分为远端保护组(GW)和非远端保护组(NGW).入选标准:发病在6 h之内,胸痛持续≥30 min且用硝酸甘油不缓解;在12导联心电图上至少有2个相邻导联ST-段抬高≥0.2 mV;梗死相关血管(IRA)近段或中段直径≥3 mm;血浆中的肌酸激酶增高.排除标准为:血流动力学状态不稳定者;严重心功能不全;多支血管病变拟行冠状动脉搭桥者;左主干病变;急性心肌梗死机械并发症.于术前、术后1 d,2 d,3 d,5 d分别测定外周血中内皮素(ET)、血浆肾索活性(PRA)、醛固酮(ALD)、血管紧张素Ⅱ(Ang Ⅱ)、去甲肾上腺素(NE)、肾上腺素(E)水平.分别对术后1,2,3,5 d的ET,PRA,ALD,AngⅡ,NE,E等数值应用成组t检验进行两组间的比较.结果 两组病例均成功植入支架,术前两组患者的神经内分泌因子水平差异无统计学意义(P＜0.05).GW组较NGW组ET,PRA,ALD,AngⅡ,NE,E等神经内分泌因子水平于术后第1天下降明显,两组差异具有统计学意义(P＜0.05).结论 急性心肌梗死急诊PCI手术中应用远端保护装置可以使神经内分泌指标降低,减少其不利影响,促进心肌的恢复.     

Early effects of experimental diabetes on central catecholamine concentrations

Six days after induction of diabetes norepinephrine (NE), 3,4-dihydroxyphenylalanine and dopamine concentrations were determined in spinal cord, cerebellum, pons/medulla oblongata and the remaining brain of diabetic rats. Only cerebellar NE levels were significantly increased by 21% compared to age-matched controls. This effect was not seen when diabetic rats received insulin replacement therapy. Fifty-two days after induction of diabetes cerebellar NE levels in diabetic rats were further increased (+37%), implying an enduring and progressive effect. The data show that even with a short period of uncontrolled diabetes central neurochemical alterations occur.     

Monoamines in the caudal neurosecretory complex: Biochemistry and immunohistochemistry

Monoaminergic inputs to the caudal neurosecretory complex (CNc) of Poecilia latipinna have been identified using histofluorescence and immunohistochemical techniques. The present study was undertaken to identify specific monoamines and determine the relative contribution of indolamines and catecholamines in supraspinal and intrinsic innervation of the nucleus. The CNc was deafferented by transecting the spinal cord rostral to the CNc. Ten days subsequently, CNc of spinal-transected and control fish were processed for either biochemical or immunohistochemical analysis. Norepinephrine and serotonin were detected in pooled samples of control CNc. Following deafferentation, the content of both monoamines was diminished. Using immunohistochemical labeling for serotonin or for the catecholamine-synthesizing enzymes, tyrosine hydroxylase (TH) or dopamine-beta-hydroxylase (DBH), the number of monoamine fibers was decreased in deafferented CNc compared to control. A substantial serotonergic innervation remains after deafferentation, as evidenced by serotonin-positive neurons and heavy, varicose fibers. Occasional TH/DBH-positive cells and fibers remain after deafferentation. These data suggest that both norepinephrine and serotonin are associated with descending supraspinal projections, while serotonin predominates as the intrinsic monoamine.     

多巴胺及去甲肾上腺素对感染性休克患者血流动力学和组织氧代谢的影响

目的探讨多巴胺(DA)及去甲肾上腺素(NE)在治疗感染性休克过程中对血流动力学和组织氧代谢的影响。方法选择我科腹部外科术后感染性休克患者46例,按随机原则分别给予DA(DA组)或NE(NE组)升压治疗。分别观察入组时、入组后1~6h的血流动力学指标[心率(HR)、平均动脉压(MAP)、心排出量指数(CI)、每搏指数(SI)、体循环阻力指数(SVRI)]、混合静脉血氧饱和度(SvO2)、早期乳酸清除率、28d死亡率;每小时尿量(UV)和12h后肌酐清除率(Ccr)。结果①两组各时间点MAP、CI、SVRI比较差异均无统计学意义,DA组的HR明显高于NE组,而SI低于NE组(P0.05)。②3h后NE组SvO2值较DA组明显增高(P0.05),6h后NE组SvO2≥65%的比例也明显高于DA组;NE组早期乳酸清除率明显高于较DA组[(24.8±15.7)%vs(16.2±14.2)%,P=0.003],NE组高的早期乳酸清除率比例明显高于较DA组,③两组6h后UV以及12h末的Ccr水平无明显差异。④两组之间28d死亡率无统计学差异。结论NE在内脏灌注和组织氧代谢方面优于DA。对于腹部外科术后感染性休克患者,NE可能是更好的选择。     

星状神经节阻滞对兔血浆去甲肾上腺素浓度的影响

目的观察星状神经节阻滞(SGB)对兔血浆去甲肾上腺素(NE)浓度的影响,探讨其治疗疼痛的可能机制.方法14只日本大耳白兔在严格无菌操作下暴露右侧星状神经节,置入并固定硬膜外导管,使其一端开口位于星状神经节附近,另一端自颈背部穿出.手术1w后利用福尔马林皮下注射法建立急性疼痛模型,随机分为对照组(A组)和SGB组(B组),每组7只.致痛60min后,B组经导管注入0.25%布比卡因(Bu)0.5ml,A组用等量的生理盐水(NS).观察致痛前10min(T0)、致痛后10min(T1)、30min(T2)、50min(T3)和应用Bu或NS后10min(T4)、30min(T5)、50min(T6)时血浆NE浓度的变化.结果致痛前两组血浆NE无差别(P＞0.05);与致痛前相比,致痛后两组NE均升高,且在T1时达高峰,在T2、T3时略有下降(P＜0.01);两组间血浆NE无明显差别(P＞0.05).与用NS前相比,用NS后A组血浆NE无统计学差异(P＞0.05);与用Bu前相比,用Bu后B组血浆NE明显下降(P＜0.05).结论星状神经节阻滞降低血浆NE浓度,NE降低可能是其治疗疼痛性疾病的机制之一.     

肌球蛋白轻链磷酸化与心肌损伤的实验研究

应用水平平板等电聚焦(电压2000V,时间2.5h、pH 4～6)、银染和凝胶光密度扫描相结合的一种新方法,研究去甲肾上腺素性心肌损伤兔心肌肌球蛋白轻链磷酸化(P-MLC/MLC×100%)的改变及α、β受体阻滞剂对该改变的影响。结果表明,去甲肾上腺素(NE,2mg/kg)显著降低心肌的P-MLC/MLC(P-MLC/MLC为35.40±5.37%;对照组为61.07±6.97%,P<0.01),酚妥拉明(10mg/只)可保护心肌P-MLC 66.43±8.43%,而普萘洛尔则无此作用(P-MLC/MLC为36.54±4.05%)。