【作者】 郭晓军；

【导师】 曹定睿；

【作者基本信息】 山西医科大学 ， 麻醉学， 2007， 硕士

【摘要】 目的:本实验旨在探讨麻醉药丙泊酚(propofol)和瑞芬太尼(remifentanil)对大鼠缺血再灌注损伤(ischemia reperfusion injury,IR)后肺泡细胞凋亡的影响。方法:清洁级雄性Wistar大鼠126只,体重280—300g。大鼠依随机原则分5组,其中6只进入空白对照组(不对动物作任何处理,直接麻醉后剖胸取肺组织及左房血检测,此组作为各组术前空白对照),假手术组(仅行右开胸和右肺门穿带)、手术组(活结阻断右肺动脉、肺静脉和右主支气管)、丙泊酚组以及瑞芬太尼组各30只,并再随机分为5小组。各小组依照结扎前及缺血30min、再灌注1、2、4hr依实验步骤取材待检。建立大鼠原位热缺血再灌注模型,于结扎前、缺血30分钟、再灌注1小时、2小时、4小时给予药物干预,采取右肺组织及右房血标本,测定①血氧分压,②肺组织湿/干重比,③光镜和透射电镜观察组织细胞形态及超微结构,确定细胞凋亡发生,④采用流式细胞仪测定肺组织中凋亡情况。结果:缺血再灌注组与假手术组比较,血氧分压降低(P＜0.05),肺组织湿/干重比增高(P＜0.05),肺泡细胞凋亡指数增高(P＜0.05),丙泊酚组、瑞芬太尼组与缺血再灌注组比较,血氧分压增高(P＜0.05),肺组织湿/干重比降低(P＜0.05),肺泡细胞凋亡指数下降(P＜0.05)。结论:丙泊酚组和瑞芬太尼组血气分析、湿干比值、细胞凋亡率等指标测定结果明显优于IR组,显示丙泊酚和瑞芬太尼在治疗剂量对IR时的细胞凋亡过程有明显的缓解作用,能够减轻肺组织IR及凋亡的程度。更多还原

【Abstract】 Objective The experiment wi1l research the effect of propofol and remifentanil against the apoptosis of alveolar cells induced by ischemia reperfusion injury.Methods 126 male Wistar rats weighing 220-250g were randomly divided into 5groups:GroupA:control group（n=6,species were taken directly after anesthesia and thoracic incision.This group served as the pre-operative controls to the other groups）,Group B:Sham group（n=30,suture was only placed in right hilus.The other operation progress and analysis of species were same to IR group）,Group C: Ischemia-reperfusion group（n=30,according to time,It is further divided into 5 sub-groups stands for before deligation,30min after ischemis,1h、2h、4h after reperfusion）,Group D:propofol treatment group（n=30,five sub-groups as groupC）, Group E:remifentanil treatment group（n=30,five sub-groups as group C）.We use the rat model of warm ischemia and repefusion in situ in single lung.After the establishment of the ischemia reperfusion in situ models,all rats will give pharmaceutical intervention.Before the ligation,after 30min of the ischemia and after 1h,2h,4h repectively of the reperfusion,We get the lung tissue and blood samples of the right atrium,then detect the partial pressure of blood oxygen, the wet weight/dry weight ratio of lung tissue and observe the configuration and ultrastructure of the tissue cells to confirm that the apoptosis happens and detect apoptosis of alveolar cells with the flow cytometer.Results Compared with shame group,Ischemia-reperfusion group showed decreased PaO₂ and elevated wet/dry ratio（P＜0.05）.Apoptotic index of lung was elevated.Compared with Ischemia-reperfusion group,propofol treatment group and remifentanil treatment group showed elevated PaO₂ and decreased wet/dry ratio （P＜0.05）.Apoptotic index of lung was decreased（P＜0.05）.Conclusions In conclusion,compared with Ischemia-reperfusion group,propofol treatment group and remifentanil treatment group showed elevated PaO₂ and decreased wet/dry ratio and apoptotic index of lung was decreased.It is said that propofol and remifentanil have suppression to the apoptosis of alveolar cells induced by ischemia reperfusion injury.更多还原