雷米芬太尼与苏芬太尼对失血性休克鼠肺内中性粒细胞聚集激活的对比研究

The effects of remifentanil versussufentanil on the infiltration and activation of neutrophil in lung after hemorrhagic shock in rats

  • 摘要: 目的: 观察失血性休克大鼠血中丙二醛(MDA)、超氧化物歧化酶(SOD)含量及肺内髓过氧化物酶(MPO)活性的变化,探讨雷米芬太尼和苏芬太尼对失血性休克大鼠炎性/应激反应的影响。方法: 健康SD大鼠72只,雌雄不拘,体重250~ 300g,建立改良Wigger失血性休克模型,股动脉放血使平均动脉压降至(5.33± 0.6 6) kPa,维持180min;随机分为三组:对照组、雷米芬太尼组、苏芬太尼组,后两组分别在复苏开始时静脉持续输注雷米芬太尼0.5μg/(kg·min)或苏芬太尼0.05μg/(kg·min)。在休克前、休克、复苏2h、复苏4h,观察上述指标的变化。每组每个时间点的动物数为6只。结果: 动物休克时血中MDA含量升高,在对照组和苏芬太尼组,MDA含量持续升高;复苏2h和4h的含量约为休克前、休克时的1.8~ 2倍(P<0.05)。静脉输注雷米芬太尼,血中MDA含量升高不明显,复苏各时间点与休克前相比均无显著性差异(P>0.05)。复苏2h、4h,雷米芬太尼组与对照组和苏芬太尼组相比,差异显著(P<0.05)。血中总SOD、肺内MPO的变化与MDA相似,复苏2h、4h雷米芬太尼组与对照组和苏芬太尼组相比,有显著性差异(P<0.05)。结论: MDA、总SOD和MPO是反映肺内中性粒细胞聚集、激活的敏感指标。等效剂量的雷米芬太尼与苏芬太尼相比,可有效抑制失血性休克上述指标的变化,对于阻断急性肺损伤向多器官衰竭的发展具有有益作用。

     

    Abstract: Objective: To explore the effects of remifentanil and sufentanil on the inflammation / stress response after hemorrhage and resuscitation in rats, we observed the changes of MDA, SOD in serum and the change of MPO in lung. Methods: We subjected 72 SD rats to controlled hemorrhagic shock (MAP=5.33 kPa) for a period of 180 minutes. Three groups of animals were included-control group, remifentanil group and sufentanil group. At the beginning of resuscitation remifentanil and sufentanil were infused intravenously at the rate of 0.5 μg/(kg·min) or 0.05 μg/(kg·min). We observed the changes of MDA and SOD in serum and the changes of MPO in lung at pre-shock, shock, post-resuscitation 2 h and 4 h. There were 6 rats in every group at each observing time. Results: The content of MDA in serum elevated after shock, the data of resuscitation 2 h, 4 h were 1.8~2.0 times that of pre-shock, shock in control group and sufentanil group (P<0.05). The level of MDA did not elevate obviously, there was no significant difference between the data of resuscitations and pre-shock (P>0.05). At the time of resuscitation 2 h and 4 h, there were significant difference among remifentanil, sufentanil and control group (P<0.05). The changes of SOD and MPO resembled that of MDA, there was significant difference between remifentanil group and the two other groups (P<0.05). Conclusion: MDA, SOD and MPO are sensitive markers that indicate the infiltration, activation of neutrophil in lung. Compare with sufentanil, remifentanil may suppress the changes of these markers significantly, and may have the advantage of blocking acute lung injury turn to MODS.

     

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