芬太尼对家兔缺血再灌注期心肌组织及血清IL-6、TNF-α的影响

目的 :观察芬太尼对家兔缺血再灌注期心肌组织及血清白介素 6 (IL 6 )、肿瘤坏死因子 (TNF α)的影响。方法 :2 4只家兔随机分为 3组。假手术组 (C组 )、缺血再灌注组 (IR组 )和芬太尼组 (F组 ) ,每组 8只。IR组行冠状动脉左前降支阻断 30min ,再灌注 3h ,于缺血前 5min(I0 )、缺血 30min(I1 )、再灌注 1h(R1 )和 3h(R2 )取颈内静脉血并于实验结束取心肌组织 ,分别测定IL 6和TNF α浓度 ,光镜下观察心肌病理结构变化。F组缺血前 2 0min缓慢静注芬太尼 5 0 μg kg后 ,以 4 0 0 μg (kg·h)速度维持 ;C组仅分离血管 ,不阻断血流 ,采样时点和检测指标均同IR组。结果 :IR组血清IL 6在R1 和R2 时持续升高 (P <0 .0 1) ,TNF α在I1 时显著升高 (P <0 .0 1) ,TNF α和IL 6水平同F组和C组差别有显著性 (P <0 .0 1) ;心肌组织中IL 6和TNF α含量明显增加 ,同F组和C组比差异有高度显著性 (P<0 .0 1)。F组血清IL 6在R2 时升高 ,为I0 的 1.33倍 (P <0 .0 5 ) ,TNF α在I1 及R1 时升高 (P <0 .0 5 ) ,R2 时降低 (P>0 .0 5 ) ;心肌组织IL 6、TNF α虽较C组有升高 ,但明显低于IR组 (P <0 .0 1)。光镜下F组心肌水肿较轻 ,白细胞浸润较少 ;IR组水肿严重 ,白细胞明显浸润。结论 :芬太尼抑制缺血再灌注心肌组织和血清IL 6?

Effect of Fentanyl on Interleukin-6 and Tumor Necrosis Factor-α in Rabbits Following Myocardial Ischemia and Reperfusion

Objective: To observe the effect of fentanyl on the production of interleukin 6(IL 6) and tumor necrosis factor alpha(TNF α) following myocardial ischemia and reperfusion. Methods: Twenty four rabbits were randomly divided into three groups: sham operation group(group C,n=8),ischemia reperfusion group(group IR,n=8)and fentanyl group(group F,n=8). Group IR was subjected to a 30 min of left anterior descending coronary artery(LAD) occlusion followed by reperfusion for 3 h. Group F with fentanyl administration(50 μg/kg) 20 min before the occlusion and followed by 400 μg/(kg·h) till the end of the experiment. IL 6 and TNF α were measured at following points: 5 min before occlusion(I 0), 30 min after occlusion(I 1), 1 h(R 1) and 3 h(R 2) after reperfusion, cardiac homogenate. The pathological changes were investigated under light microscope. Results: In group F, serum IL 6 increased at R 2(P<0.05), while serum TNF α increased at I 1 and R 1(P<0.01), and decreased at R 2(P>0.05), myocardial TNF α and IL 6 were higher than group C(P>0.01). In group IR, serum IL 6 rose obviously at R 1(P<0.01), and were kept at a higher level till the end of the reperfusion, serum TNF α reached it's peak at R 1(P<0.01) and decreased a little at R 2(P<0.01), however, still higher as compared with group C and F(P<0.01). Levels of myocardial IL 6 and TNF α were higher than those in group F and group C(P<0.01). Under light microscope, mild myocardium edema and only a few inflammatory cells were found in group F. Such changes were more serious in group IR. Conclusion: Fentanyl can inhibit the production and release of serum and myocardial IL 6 and TNF α following myocardial ischemia and reperfusion.