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中国临床药理学与治疗学 ›› 2002, Vol. 7 ›› Issue (2): 119-123.

• 基础研究 • 上一篇    下一篇

阿芬太尼对再灌注心肌功能的保护作用及其机制

陈猛, 曾因明1, 段世明1, 沈志忠, 许鹏程1   

  1. 常州市第一人民医院麻醉科, 常州 213003;
    1徐州医学院江苏省麻醉学重点实验室, 徐州221002
  • 收稿日期:2001-11-15 修回日期:2001-12-10 出版日期:2002-04-26 发布日期:2020-11-27
  • 通讯作者: 陈猛, 男, 医学博士, 从事麻醉药理学研究。现在上海市第一人民医院麻醉科, 200080。Tel:021-63240090-4718 E-mail:mengchen2000@hotmail.com
  • 作者简介:曾因明, 男, 教授, 博士生导师。

Alfentanil protects the isolated rat heart against ischemia and reperfusion injury via opioid receptors and NO linked mechanisms

CHEN Meng, ZENG Yin-Ming1, DUAN Shi-Ming1, SHEN Zhi-Zhong, XU Peng-Cheng   

  1. Department of Anesthesiology, Changzhong First People's Hospital, Changzhou 213003;
    1Jiangsu Provincial Key Laboratory of Anesthesiology, Xuzhou Medical College, Xuzhou221002
  • Received:2001-11-15 Revised:2001-12-10 Online:2002-04-26 Published:2020-11-27

摘要: 目的: 研究阿芬太尼对缺血再灌注心肌功能的保护作用及其作用机制。方法: 采用 Langendorff离体大鼠心脏模型, 以停灌的方式造成全心缺血25 min, 然后复灌 30 min, 药物于缺血前 10 min给予并持续到复灌末。观察 50 μg·L-1 和 100 μg·L-1阿芬太尼及其与纳洛酮和 L-NAME 合用时对缺血前及再灌注期间左心功能的影响, 并测定再灌注末时心肌组织 ATP 和 NOS 的含量。 结果: (1) 在非缺血情况下, 100 μg·L-1阿芬太尼能使 HR 减慢, 对LVEDP、LVDP、±dp/dtmax 和 CF 无明显影响;(2)50 μg·L-1 和 100 μg·L-1 阿芬太尼均能明显促进再灌期间左心功能和冠脉流量的恢复, 且 100 μg·L-1阿芬太尼比 50 μg·L-1 阿芬太尼作用更明显;(3)200 μg·L-1 纳洛酮和 100 μmol·L-1 L-NAME 均削弱了阿芬太尼对缺血再灌注心肌功能恢复的有利作用。结论: 阿芬太尼对离体大鼠的心肌功能影响轻微且能促进缺血再灌注后心肌功能的恢复, 其作用机制可能与阿片受体和内皮细胞释放的一氧化氮有关。

关键词: 阿芬太尼, 纳洛酮, L-NAME, 缺血再灌注, 心肌功能

Abstract: AIM: To investigate if alfentanil protects the isolated rat heart against myocardial reperfusion injury andif the mechanism of this protection ismediated via opi-oid receptors and NO-dependent pathways.METHODS: Langendorff rat hearts were perfused at constant pressure with Kreb-Henseleit (K-H) buffer for 20 min and then were perfusedwith test solution:K-H buffer or K-H buffer containing alfentanil 50 μg·L-1, alfentanil 100 μg·L-1, naloxone 200 μg·L-1, alfentanil 100 μg·L-1 +naloxone 200 μg·L-1, L-NAME 100 μmol·L-1 and alfentanil 100 μg·L-1 +L-NAME 100 μmol·L-1.After 10 min of this, the hearts were subjected to 25 min normothermic (37 ℃) global ischemia followed by 30 min reperfusion with the same test solution as before.To evaluate myocar-dial function, LVEDP, LVDP, ±dp/dtmax, HR and CF were measured at the 20th, 25 and 30th minute of perfu-sion and the 1st, 3rd, 5th, 10th, 20th and 30th minute of reperfusion.After experiment, the NOS and ATP con-tent of myocardium were assessed.RESULTS: Before is-chemia, alfentanil 100 μg·L-1 decreased the HR at the 30th minute compared with the 20th minute(P<0.05). Treatment with 50 μg·L-1 alfentanil and alfentanil 100 μg·L-1 improved post-ischemic mechanical function assessed by LVEDP, LVDP and ±dp/dt max compared with controls after 30 min of reperfusion(P<0.05 or P <0.01).Furthermore, 100 μg·L-1 alfentanil improved post-ischemic mechanical function better than 50 μg·L-1 alfentanil indicated by lower LVEDP and higher-dp/ dt max (P<0.05).These effects were attenuated by 200 μg·L-1 naloxone and 100 μmol·L-1 L-NAME.CONCLUSION: Alfentanil have few inhibitive effects on the mechanical function of the non-ischemic hearts and have dose-depended protective effects against myocardial reperfusion injury by a mechanism mediated via opioid re-ceptors and NO-dependent pathways in rats.

Key words: alfentanil, naloxone, L-NAME, my-ocardial reperfusion injury

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