依托咪酯预处理对犬肝脏缺血再灌注损伤时细胞凋亡的影响

目的探讨依托咪酯（etomidate）预处理对肝脏缺血再灌注损伤细胞凋亡的影响。方法 20只杂种犬随机分组（n=4）：假手术组、缺血再灌注组、小剂量依托咪酯预处理组、大剂量依托咪酯预处理组,开放液路,监测平均动脉压（MAP）,用3%戊巴比妥钠30mg/kg静注间断给药维持麻醉,静注维库溴铵0.3mg/kg,气管插管后控制呼吸。缺血再灌注组、小剂量依托咪酯预处理组、大剂量依托咪酯预处理组分别于肝缺血前30min静注生理盐水,依托咪酯0.6mg/kg（低浓度）,依托咪酯1.5mg/kg（高浓度）,阻断肝第一、第二肝门建立肝缺血再灌注模型。除Sham组外,所有犬肝脏都经历30min缺血和120min再灌注。再灌注120min时,取各组缺血区肝脏组织,TUNEL法测定肝脏细胞的凋亡情况,免疫组化法测定各组Bcl-2和Bax的表达。结果TUNEL肝细胞凋亡：高浓度治疗组明显低于缺血组和低浓度治疗组（P〈0.05）;BCL-2蛋白表达：高浓度治疗组明显高于缺血组和低浓度治疗组（P〈0.05）;BAX蛋白表达：高浓度治疗组与低浓度治疗组明显低于缺血组和假手术组（P〈0.05）。结论依托咪酯预处理可上调Bcl-2蛋白表达,下调Bax蛋白的表达,抑制肝细胞凋亡,减轻缺血再灌注损伤。

The influence of pre-dealed with etomidate on liver ischemia-reperfusion injury in apoptosis

Objective To explore the anti-apoptosis effect of etomidate in the process of liver ischemia-reperfusion injury.Methods 20 dogs were used to make the animal model of different grade of liver ischemia-reperfusion injury,divide into 4 groups in random,sham group,liver ischemia-reperfusion injury group,liver ischemia-reperfusion injury deal with low-dose(0.6mg/kg) etomidate group,liver ischemia-reperfusion injury deal with high-dose(1.5mg/kg) etomidate group,liver ischemia-reperfusion injury group was injected...