芬太尼联合东莨菪碱预处理对大鼠心肌缺血再灌注损伤的影响

目的 探讨芬太尼联合东莨菪碱预处理对大鼠心肌缺血再灌注后的心肌保护效应.方法 24只雌性大鼠随机分为3组（每组8只）：即C组（心肌缺血再灌注组）、F组（芬太尼组）、F＋D组（芬太尼＋东莨菪碱组）.记录缺血前、再灌注即刻、再灌注30 min、再灌注120 min等的心率（HR）、左心室收缩压峰值（LVSP）、左心室舒张末压（LVEDP）、左心室收缩及舒张最大压力变化速率（±dp/dtmax）.再灌注120 min后,均取动脉血样3 mL,测定血清超氧化物歧化酶（SOD）活力、血清丙二醛（MDA）浓度、一氧化氮（NO）的浓度进行统计分析.结果 血液动力学的各组时间节点间的HR和LVEDP无显著差异（P＞0.05）,LVSP、±dp/dtmaxF组在再灌注30 min、120 min时较C组显著升高（P＜0.05）,F＋D组则显著高于F组（P＜0.05）.生化指标中F＋D组的SOD活力与C组和F组比较无显著差异（P＞0.05）,F＋D组的MDA浓度显著低于其余两组（P＜0.05）,F组和F＋D组的NO浓度都明显高于C组（P＜0.05）.各组心律失常严重程度评分,F＋D组最低（P＜0.05）.结论 芬太尼联合东莨菪碱比单纯使用芬太尼预处理具有更好的对心肌缺血再灌注损伤的保护作用.

Effects of Pretreatment with Fentanyl Combine Scopolamine on Myocardial Ischemia and Reperfusion Injury in Rats

To study the protective effects of pretreatment with fentanyl combine scopolamine on myocardial ischemia and reperfusion injury in rats.Twenty-four SD rats were randomly divided into three groups（n =8 in each group）：control group （group c,acute myocardial ischemia and reperfusion injury group） 、group F （fentanyl group,the rats intravenously injected with fentanyl 0.05mg/kg at 10min before myocardial ischemia） and group F ＋ D （fentanyl ＋scopolamine group,the rats intravenously injected with fentanyl 0.05mg/kg and scopolamine 0.3mg/kg at 10min before myocardial ischemia）.Heart rate （HR）,left ventricular systolic pressure （LVSP）,left ventricular end diastolic pressure （LVEDP）,maximum positive and minimum negative left ventricular pressure derivatives （± dp/dtmax） were continuously monitored and recorded at baseline,30min after ischemia,30min and 120min after reperfusion process.Contents of superoxide dismutase （SOD）,malonyldialdehyde （MDA） and NO level in artery blood of rats were detected after reperfusion 120min.There were no significant difference in HR and LVEDP at any measurement point during the experiment among all groups （P ＞ 0.05）.LVSP and ± dp/dtmax were significantly higher in group F than in group C at 30min、120min after reperfusion （P ＜ 0.05）,and these were as well significantly higher in group F ＋ D than in group F （P ＜ 0.05）.The serum activity of SOD was no significant difference in all groups （P ＞ 0.05）.And the serum concentration of MDA was significantly lower in group F ＋ D than in group F and group C （P ＜ 0.05）.The serum concentration of NO was significantly higher in group F and group F ＋ D than in group C （P ＜ 0.05）.The arrhythmia score was significantly lower in group F ＋ D than in else groups （P ＜ 0.05）.The protective effects of pretreatment with fentanyl combine scopolamine on myocardial ischemia and reperfusion injury in rats was better than fentanyl single.