摘要
目的探讨右美托咪定对糖尿病大鼠心肌缺血再灌注损伤(MIRI)的影响。方法选取66只雄性SD大鼠,随机分为假手术组、缺血再灌注组、右美托咪定组,每组10只,糖尿病假手术组、糖尿病缺血再灌注组、糖尿病右美托咪定组,每组12只。大鼠腹腔注射链脲佐菌素建立糖尿病模型,右美托咪定组在缺血前30 min给予右美托咪定,其余组在同一时间经股静脉给予等量生理盐水。比较6组大鼠一般情况、血流动力学、心肌梗死面积及心肌组织中肿瘤坏死因子-α(TNF-α)和白介素-1β(IL-1β)水平。结果与正常组比较,糖尿病组体质量、全心质量减轻,空腹血糖(FBG)、总胆固醇(TC)及甘油三酯(TG)水平升高(P<0.05)。除假手术组与糖尿病假手术组之外,其余4组在缺血后与再灌注后的平均动脉压(MAP)、心率与心率收缩压乘积(RPP)水平低于基线水平(P<0.05);与缺血再灌注组比较,右美托咪定组在缺血后及再灌注后30 min时MAP、心率与RPP水平降低,再灌注120 min后升高(P<0.05);与糖尿病缺血再灌注组比较,糖尿病右美托咪定组在缺血后及再灌注后MAP、心率与RPP水平比较差异无统计学意义(P>0.05),再灌注后120 min升高(P<0.05)。与缺血再灌注组比较,右美托咪定组梗死区心肌/缺血未梗死心肌(AN/AAR)降低(P<0.05);与右美托咪定组比较,糖尿病右美托咪定组AN/AAR升高(P<0.05),与糖尿病缺血再灌注组比较,糖尿病右美托咪定组AN/AAR降低(P<0.05)。与缺血再灌注组比较,右美托咪定组的血清TNF-α和IL-1β水平降低(P<0.05);与糖尿病缺血再灌注组比较,糖尿病右美托咪定组血清TNF-α和IL-1β水平降低(P<0.05)。结论对于正常大鼠,右美托咪定可以有效改善大鼠血流动力学指标、心肌梗死面积及炎性因子水平,对MIRI有防护作用;当并发糖尿病时,右美托咪定对MIRI仍有一定防护作用。
Objective To investigate effect of Dexmedetomidine （DEX） on myocardial isehemia-reperfusion injury in rats with diabetes mellitus. Methods A total of 66 male SD rats were randomly divided into sham operation group （ group A, n = 10）, isehemia reperfusion group （ group B, n = 10）, Dexmedetomidine group （ group C, n = 10） and diabetic sham operation group （ group D, n = 12）, diabetic isehemia repeffusion group （ group E, n = 12） and diabetic Dexmedetomidine group （group F, n = 12）. Rat models were established by injecting Streptozotoein intraperitoneally. Group C was given DEX 30 minutes before isehemia, while other groups were given the same volumes of normal saline through femoral vein at the same time. General situation, hemodynamies, area of myocardial infarction, and levels of tumor necrosis faetor-a （TNF-a） and interleukin-1β （IL-1β） in myoeardium tissues were compared among 6 groups. Resuits Compared with those in normal group, levels of body weight （BW） and total heart mass （HW） were reduced, while levels of fasting blood glucose （FBG）, total cholesterol （TC） and triglyeeride （TG） were increased in the 6 groups （P 〈 0.05 ）. Except for group A and D, mean arterial pressure （ MAP）, heart rate （ HR）, and rate-pressure product （RPP） levels after isehemia and reperfusion in other 4 groups were lower than the baseline level （P 〈 0.05 ）. Compared with those in group B, MAP, HR and RPP levels after isehemia and 30 min after reperfusion were significantly decreased, while the levels were increased 120 min after reperfusion in group C （ P 〈 0.05 ）. Compared with those in group E, in group F, the differences in MAP, HR and RPP levels after isehemia and reperfusion showed no significant differenees （P 〉 0.05 ）, while the levels were increased 120 min after reperfusion （P 〈 0.05）. Compared with that in group B, cardiac muscle in infarct area/cardiac muscle in isehemie noninfarct area level in group C （P 〈 0.05 ）. Compared with those in group B, serum TNF-a and IL-1β levels were decreased in group C （P 〈 0.05 ）. Compared with those in group E, TNF-a and IL-1β levels were decreased in group F （P 〈 0.05 ）. Conclusion Among normal rats, Dexmedetomidine may effectively improve hemodynamie indexes, area of myocardial infarction and inflammatory factors levels, and it has proteetive effeet for myoeardial isehemia-reperfusion injury, and Dexmedetomidine still has a certain protective effeet in rats with diabetes mellitus.
作者
张世平
王臻
金梅梅
朱婧
常建华
ZHANG Shi-ping;WANG Zhen;JIN Mei-mei;ZHU Jing;CHANG Jian-hua(Department of Anesthesiology,Shaanxi Provincial People＇s Hospital,Xihn 710068,China;Emergency Department,the First Affiliated Hospital of Xi＇an Jiao Tong University,Xi＇an 710061,China)
出处
《解放军医药杂志》
CAS
2018年第7期7-11,共5页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
陕西省社会发展科技攻关项目(2015SF103)
