田杰,米娜,吕之勇,杨春涛,刘尊鸿
TIAN Jie,MI Na,LYU Zhiyong,YANG Chuntao,LIU Zunhong

• 1:荆门市第二人民医院麻醉科
• 2:荆门市康复医院麻醉科

摘要(Abstract)：

目的 探讨不同浓度七氟醚对心肌缺血再灌注(MIR)大鼠心肌及神经组织损伤的影响。方法 选取成功构建MIR模型的健康雄性大鼠50只，随机均分为模型组[(吸入氧气(O_2)]、1%七氟醚+O_2组(A组，吸入1%七氟醚+O_2)、2%七氟醚+O_2组(B组，吸入2%七氟醚+O_2)、3%七氟醚+O_2组(C组，吸入3%七氟醚+O_2)及4%七氟醚+O_2组(D组，吸入4%七氟醚+O_2);各组大鼠吸入相应气体6 h,测量血流动力学指标[心率(HR)、平均动脉压(MAP)、心率与收缩压乘积(RPP)];之后麻醉处死各组大鼠，取心脏分离左心室称重，制作切片检测各组大鼠心肌组织危险区和梗死区面积；取左心室前壁心肌组织制作心肌组织匀浆，使用黄嘌呤氧化酶法和硫代巴比妥酸显色法测定各组大鼠心肌组织超氧化物歧化酶(SOD)和丙二醛(MDA)活性、经酶法检测各组大鼠脑组织神经元特异性烯醇化酶(NSE)和S100钙结合蛋白B(S100B)蛋白、检测各组大鼠心肌损伤指标[心肌磷酸化蛋白激酶B(p-Akt)、总蛋白激酶B(t-Akt)、B细胞淋巴瘤蛋白2(Bcl-2)及心肌细胞凋亡率];抽取尾静脉血，采用酶联免疫吸附法(ELISA)检测各组大鼠血清炎性因子[血清核转录因子-kB(NF-kB)、肿瘤坏死因子-α(TNF-α)及白细胞介素-6(IL-6)]水平。结果 与模型组比较，A、B、C及D组大鼠心肌梗死区域面积均缩小，血清NF-kB、TNF-α及IL-6水平均降低，心肌组织SOD水平升高、MDA水平降低，心肌细胞凋亡率、p-Akt、t-Akt及Bcl-2水平均降低，脑组织NSE、S100B蛋白水平均降低，且呈现剂量反应，差异均有统计学意义(P<0.05);各组大鼠HR、MAP及RPP水平比较，差异均无统计学意义(P>0.05)。结论 不同浓度七氟醚均可改善MIR大鼠的炎性反应，缓解氧化应激反应，减少心肌损伤，缩小心肌梗死面积，保护大脑神经功能，且作用效果呈现剂量反应。
Objective To investigate the effects of sevoflurane at different concentrations on myocardial and nerve tissue injury in myocardial ischemia reperfusion(MIR) rats. Methods Fifty healthy male rats that successfully constructed MIR model were randomly divided into model group [(inhaled oxygen(O_2)], 1% sevoflurane + O_2 group(group A, inhaled 1% sevoflurane + O_2), 2% sevoflurane + O_2 group(group B, inhaled 2% sevoflurane + O_2), 3% sevoflurane + O_2 group(group C, inhaled 3% sevoflurane + O_2) and 4% sevoflurane + O_2 group(group D, inhaled 4% sevoflurane + O_2). Subjects in each group inhaled gas for 6 h. The hemodynamic indexes [heart rate(HR), mean arterial pressure(MAP), and the product of heart rate and systolic blood pressure(RPP)] were detected. At the end of anesthesia, the rats in each group were executed for the hearts. The left ventricle was separated and weighed; slices were prepared to detect the risk area and infarct area of myocardial tissue in each group. The myocardial tissue homogenate was prepared from the myocardial tissue of left ventricle anterior wall. The activities of superoxide dismutase(SOD) and malondialdehyde(MDA) in the myocardial tissue of rats in each group were measured by xanthine oxidase method and thiobarbituric acid color method. Neuron specific enolase(NSE) and Ca-binding protein B(S100 B) were detected by enzyme method; myocardial injury indexes of rats in each group [myocardial phosphorylated protein kinase B(p-Akt), total protein kinase B(t-Akt), B-cell lymphoma protein 2(Bcl-2), and cardiomyocyte apoptosis rate] were detected. Serum inflammatory factors [serum nuclear transcription factor kB(NF-kB), tumor necrosis factor-α(TNF-α), and interleukin-6(IL-6) were detected by enzyme-linked immunosorbent assay(ELISA)]. Results Compared with the model group, the area of myocardial infarction in groups A, B, C, and D decreased, and the levels of serum NF-kB, TNF-α and IL-6 decreased on average; SOD level in myocardial tissue increased, MDA level decreased; cardiomyocyte apoptosis rate, p-Akt, t-Akt, and Bcl-2 levels decreased; NSE and S100 B protein levels in brain tissue decreased, and presented in dose response, differences were statistically significant(P<0.05). There was no statistical significance in level comparison of HR, MAP and RPP in each group(P>0.05). Conclusion Sevoflurane of different concentrations can improve the inflammatory response of MIR rats, alleviate the oxidative stress response, reduce myocardial injury, reduce the area of myocardial infarction, and protect brain nerve function. The effect shows a dose response.

关键词(KeyWords)： 心肌缺血;再灌注;七氟醚;不同浓度;S100钙结合蛋白B;神经元特异性烯醇化酶;神经功能
myocardial ischemia;reperfusion;sevoflurane;different concentrations;S100 calcium-binding protein B(S100B);neuron-specific enolase(NSE);nerve function

Abstract:

Keywords:

基金项目(Foundation): 湖北省卫生健康委员会科研项目(WJ2019M365)

作者(Author): 田杰,米娜,吕之勇,杨春涛,刘尊鸿
TIAN Jie,MI Na,LYU Zhiyong,YANG Chuntao,LIU Zunhong

DOI: 10.19367/j.cnki.2096-8388.2023.01.007

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