瑞芬太尼对大鼠心肌缺血再灌注时血清TNF-α、IL-1β和IL-6浓度的影响

目的 探讨瑞芬太尼对大鼠心肌缺血再灌注时血清肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)及白细胞介素-6(IL-6)浓度的影响.方法 雄性SD大鼠32只,体重200～250 g,随机分为假手术组(S组)、缺血再灌注组(I/R组)、缺血预处理组(IP组)和瑞芬太尼组(R组),每组8只.I/R组阻断冠状动脉左前降支(LAD)30 min,开放120 min;IP组阻断LAD 5 min,开放10 min,阻断30 min,开放120 min;R组静脉输注瑞芬太尼0.5 μg·kg-1·min-1 20 min,阻断LAD 30 min,开放120 min,此期间静脉输注100 μg/L瑞芬太尼,速率0.5 μg·kg-1·min-1.分别于再灌注120 min取颈内静脉血样,并取左心室心肌组织.ELISA法测定血清TNF-α、IL-Iβ及IL-6浓度,电镜下观察心肌细胞超微结构.结果 与S组比较,其余3组血清TNF-α、IL-1β和IL-6浓度升高(P＜0.01);与I/R组比较,IP组和R组血清TNF-α、IL-1β和IL-6浓度均降低(P＜0.01);与IP组比较,R组血清TNF-α和IL-1β浓度降低(P＜0.05).R组和IP组心肌细胞损伤程度轻于I/R组.结论 瑞芬太尼可通过降低血清TNF-α、IL-1β和IL-6浓度减轻大鼠心肌缺血再灌注损伤.

Effects of remifentanil on serum concentration of TNF-α,IL-1β and IL-6 following myocardial ischemia-reperfusion injury in rats

Objective To investigate the effects of remifentanil on the serum concentrations of TNF-α,IL-1β and IL-6 following myocardial ischemia-reperfusion(I/R)injury in rats.Methods Thirty-two male SD rats weighing 200-250 g were randomly divided into 4 groups(n=8 each):group S sham operation;group I/R;group IP ishemic preconditioning and group R remifentanil + I/R.In group I/R,anterior descending branch of left coronary artery(LAD)was accluded for 30 min,followed by 120 min reperfusion.In group IP,LAD was occluded for 5 min,followed by 10 min reperfusion,and then occluded for 30 min,followed by 120 min reperfusion.After this process.Blood samples from internal jugular vein and left ventricle myocardium tissue were taken at 120 min after the start of reperfusion for the determination of the serum concentrations of TNF-α,IL-1β and IL-6 by ELISA,and the myocardial histopathological changes were observed with electron microscopy.Results The serum concentrations of TNF-α,IL-1β and IL-6 were significantly higher in the other 3 groups than in group S,while significantly lower in group IP and group R than in group I/R(P＜0.01).The serum concentrations of TNF-α and IL-1β were significantly lower in group R than in group IP(P＜0.05).Myocardium injury was slighter in group R and group IP than in group I/R(P＜0.01).Conclusion Remifentanil can reduce the myocardial ischemiareperfusion injury through decreasing the serum concentrations of TNF-α,IL-1β and IL-6.