贵州医科大学学报

2012, v.37;No.158(05) 493-496

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瑞芬太尼对兔离体心脏传导系统及心肌M_2胆碱能受体表达的影响
The Effects of Remifentanil on Conduction System in Isolated Rabbit Heart and the Expression of Cardiac M_2 Receptors

史静;高鸿;安裕文;方开云;何祥;马国才;
SHI Jing,GAO Hong,AN Yuwen,Fang Kaiyun,HE Xiang,MA Guocai(Department of Anesthesiology,the Affiliated Hospital of Guiyang Medical College,Guiyang 550004,Guizhou,China; Department of Anesthesiology,People′s Hospital of Guizhou Province,Guiyang 550002,Guizhou,China; Department of Anesthesiology,Central Hospital of Jiangmen city,Jiangmen 529030,Guangdong,China)

摘要(Abstract):

目的:观察瑞芬太尼对兔离体心脏传导系统及M2胆碱能受体表达的影响,探讨其引起心率减慢的机制。方法:家兔32只离体心脏,随机分为C、R1、R2、R3四组,每组8只,C组灌注K-H液40 min;R1组、R2组和R3组先灌注K-H液15 min,再分别灌注含瑞芬太尼4、12或36μg/L的K-H液25 min;记录灌流瑞芬太尼前(T0),灌流10 min(T1)、20 min(T2)时的心率(HR)、窦房结传导时间(SACT)、窦房结功能恢复时间(SNRT)、校正的窦房结功能恢复时间(CSNRT);取右心房心肌组织,Western blot法检测心肌M2胆碱能受体的表达。结果:R1组于T1时点和T2时点与C组比较,虽然HR减慢,但SACT、SNRT、CSNRT测定无明显改变;R2组T1、T2时点较C组HR减慢,SACT、SNRT、CSNRT时程延长;T1和T2时点R3组较C组、R3组较R1组、R3组较R2组HR均显著减慢,SACT、SNRT、CSNRT时程明显延长;R2、R3两组T1、T2时点分别与T0比较,T2时点与T1时点比较,HR减慢、SACT、SNRT、CSNR时程延长;R1、R2、R3组心肌M2胆碱能受体表达均较C组显著上调;R2和R3两组较R1组、R3组较R2组M2受体蛋白表达上调。结论:瑞芬太尼可以使兔离体心脏的心率减慢,并抑制兔心脏的传导系统,这些作用均呈时间、呈剂量依赖性,其作用机制可能与瑞芬太尼上调心肌组织M2受体有关。
Objective: To investigate the effects of remifentanil on conduction system of isolated rabbit heart and the expression of cardiac M2 receptors,and so as to explore the machnism of bradycardia caused by remifentanil preliminarily.Methods: Thirty-two rabbits were randomly divided into four groups: group C,R1,R2 and R3 with 8 in each group.Rabbits in group C were perfused with Krebs-Hensleit(K-H) buffer for 40 minutes.Rabbits in group R1,R2 and R3 were perfused with K-H buffer for 15 minutes and then were perfused with K-H buffer which contained 4,12 and 36 μg/L remifentanil for 20 minutes respectively.HR,sinoatrial conduction time(SACT),sinoatrial node recovery time(SNRT) and corrected sinoatrial node recovery time(CSNRT) were recorded before perfusion(T0) and after perfusion for 10 minutes(T1)and 20 minutes(T2).The expression of M2 receptor protein in right atrial myocardium was determined by Western blotting.Results: Compared with group C,HR in group R1 was slower at T1 and T2,but SACT,SNRT and CSNRT did not change significantly.Compared with group C,HR in group R2 was slower at T1 and T2,SACT,SNRT and CSNRT prolonged.Compared with groups C,R1 and R2,HR in group R3 was slower at T1 and T2,and SACT,SNRT and CSNRT prolonged obviously.Compared with T0,HR in group R2 and R3 was slower at T1 and T2,and SACT,SNRT and CSNRT prolonged.Compared with T1,the HR in group R2 and R3 was slower at T2,and SACT,SNRT and CSNRT prolonged.Compared with group C,The expression levels of M2 receptor protein in groups R1,R2 and R3 increased successively.Conclusions: Remifentanil can decrease heart rate of rabbits.Clinically used dosage of remifentanil has no influence on the conduction system of rabbit heart,but large dosage of remifentanil can depress the conduction system.Remientanil can upregulate the expression of myocardial M2 receptor.All of effects act in dose and time dependent manner.

关键词(KeyWords): 镇痛药,阿片类;兔;心脏传导系统:受体,胆碱能
analgesics,opioid;rabbits;heart conduction system;receptors,cholinergic

Abstract:

Keywords:

基金项目(Foundation): 贵州省卫生厅基金资助

作者(Author): 史静;高鸿;安裕文;方开云;何祥;马国才;
SHI Jing,GAO Hong,AN Yuwen,Fang Kaiyun,HE Xiang,MA Guocai(Department of Anesthesiology,the Affiliated Hospital of Guiyang Medical College,Guiyang 550004,Guizhou,China; Department of Anesthesiology,People′s Hospital of Guizhou Province,Guiyang 550002,Guizhou,China; Department of Anesthesiology,Central Hospital of Jiangmen city,Jiangmen 529030,Guangdong,China)

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DOI: 10.19367/j.cnki.1000-2707.2012.05.011

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