舒芬太尼延迟预处理对兔心肌缺血再灌注损伤的影响

Objective To investigate whether delayed preconditioning with sufentanil can protect against myocardial ischemia and reperfusion (IR) injury and the possible mechanism. Methods Thirty-six male New Zealand white rabbits 8-18 months old weighing 2.0-2.4 kg were used in this study. The animals were anesthetized with iv etomidate 2 mg/kg, tracheostomized and mechanically ventilated (VT 10-12 ml/kg, RR 20-25 bpm, FiO2 100%). Carotid artery and jugular vein were cannulated for BP and HR monitoring and fluid administration.Myocardial ischemia was induced by 30 min of occlusion of anterior descending branch of left coronary artery followed by 3 h of reperfusion. The animals were randomly assigned to one of 5 groups based on the sufentanil and/or naloxone the animals received 24 h before myocardial ischemia: group Ⅰ received normal saline (group IR,n=9); greup Ⅱ sufentanil 5 μg/kg (group S1, n=6); group Ⅲ sufentanil 10 μg/kg (group S2, n=9); group Ⅳ naloxone 10 mg/kg (group N, n =6) and group Ⅴ naloxone 10 mg/kg + sufentanil 5 μg/kg (group NS, n =6). Myocardial infarct size was measured using triphenyl tetrazolium (TIC) staining. Myocardial apoptosis was detected by TUNEL, and Bcl-2 and Bax protein expression was determined by immuno-histochemistry in group IR and S2. Results Sufentanil produced a dose-dependent reduction in infarct size as compared with group IR.Naloxone had no effect on infarct size but partially abolished sufentanil-induced cardio-protection. Sufentanil significantly decreased myocardial apoptosis and Bax protein expression but increased Bcl-2 protein expression as compared with group IR. Conclusion Sufentanil produces a delayed preconditioning against myocardial IR injury through activating opioid receptors and inhibiting cadiomyocyte apoptosis.

Effect of delayed preconditioning with sufentanil on myocardial ischemia and reperfusion injury in rabbits