丙泊酚对代谢性酸中毒心脏功能的双重影响
Double effects of propofol on cardiac function of rats with metabolic acidosis
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摘要: 目的 探讨丙泊酚对代谢性酸中毒心脏功能的影响。 方法 应用改良Langendorff装置,制备离体心脏代谢性酸中毒模型。将24只SD大鼠随机分为对照组(C组)、丙泊酚25μmol/L组(PL组)和丙泊酚50μmol/L组(PH组),每组8只。C组用pH=7.4的K-H液平衡灌注40min,然后用pH=6.5的K-H液酸化20min造成心脏整体的代谢性酸中毒,用pH=7.4的K-H液恢复灌注30min;PL组和PH组的灌注方式与C组相同,在平衡灌注25min后向K-H液中加入相应浓度的丙泊酚。记录酸化前,pH恢复后1、5、10、20和30min时的心率(HR)、左室发展压(LVDP),左室压力变化速率(±dP/dtmax),灌注环路内压力,心肌含水量(MWC)。 结果 在pH恢复初期(10min之内),PH组和PL组的HR、LVDP和±dP/dtmax的恢复率与C组比较均有所降低,但PH组降低有统计学意义(P<0.05)。在pH值恢复后期(20min后),PL组心功能的各项指标的恢复率均有所上升,部分指标略超过C组,但无统计学意义;而PH组的各项指标与C组比较仍略低,但无统计学意义。PL组和PH组环路内压力,心肌含水量与C组比较均有所降低,PL组降低显著(P<0.05)。 结论 适当浓度的丙泊酚对酸中毒心脏有一定的保护作用,在本研究实验条件下25μmol/L丙泊酚在心功能恢复、心肌灌注的改善以及降低心肌水肿等方面均优于50μmol/L丙泊酚。Abstract: Objective To study the effect of propofol on cardiac function of rats with metabolic acidosis. Methods A metabolic acidosis model of in vitro rat heart was established with modified Langendoff apparatus.Twenty-four SD rats were randomly divided into control group,25mmol/L propofol group(PL group) and 50mmol/L propofol group(PH group),8 in each group.Metabolic acidosis was induced by perfusion with K-H solution(pH=7.4) for 40min,then with acidic K-H solution(pH=6.5) for 20 min and K-H solution(pH =7.4) for 30min.Propofol was added into the K-H solution 25min after stable perfusion.Heart rate(HR),left ventricular develop pressure(LVDP),left ventricular pressure ±dP/dtmax,perfusion circuit pressure and myocardial water content(MWC) were recorded before acidosis and 1,5,10,20 and 30min after reperfusion. Results The HR,LVDP and left ventricular pressure ±dP/dtmax were lower in PL and PH groups than in control group and significantly lower in PH group than in control group during the 10min reperfusion(P<0.05).The pH value was higher in PL group than in control group and lower in PH group than in control group during the 20min reperfusion(P<0.05).No significant difference was observed in perfusion circuit pressure and MWC among the 3 groups.However,the perfusion circuit pressure and MWC were significantly lower in PL and PH groups than in control group(P<0.05). Conclusion Appropriate propofol concentration can protect the heart of rats against metabolic acidosis.The effect of 25mmol/L propofol is better than 50mmol/L propofol on recovery of cardiac function and improvement of cardiac muscle reperfusion and edema.