芬太尼和氯胺酮影响烧伤早期应激和炎症反应的对比分析

Comparison of the influence of fentanyl with that of ketamine on stress and inflammatory reaction in burned mice in early stage

目的 :研究小鼠烧伤后早期使用枸橼酸芬太尼和盐酸氯胺酮对血清皮质酮和TNF -α以及肝组织糖皮质激素受体的影响 ,初步探讨并比较芬太尼和氯胺酮对创伤早期应激和炎症反应的不同作用。方法 :4 0只雄性BALB/c小鼠 ,随机分为正常对照组、烧伤对照组、芬太尼组及氯胺酮组。小鼠Ⅲ度 15 0～ 2 0 0 %背部烧伤。烧伤后 4h测定血清皮质酮浓度及TNF -α水平 ,用westernbolt在蛋白水平测定肝组织糖皮质激素受体。结果 :烧伤对照组与正常对照组相比 ,血清皮质酮浓度明显升高 ,TNF -α水平显著增高 ,而肝组织糖皮质激素受体明显降低 ;芬太尼组血清皮质酮浓度及TNF -α水平显著低于烧伤对照组 ,但仍显著高于正常对照组 ,其肝组织糖皮质激素受体有所增加 ,但仍显著低于正常对照组。氯胺酮组血清皮质酮浓度显著低于烧伤对照组 ,肝组织糖皮质激素受体和血清TNF -α与正常对照组相差不显著。结论 :小鼠烧伤早期引起明显的应激和炎症反应 ,可表现为血清皮质酮明显升高 ,而其受体在蛋白水平明显降低 ,血清TNF -α水平显著增高。芬太尼和氯胺酮均对其具有一定抑制作用 ,但氯胺酮的作用明显比芬太尼强。

Objective: To evaluate the different effects of ketamine and fentanyl on serum corticosterone, serum tumor necrosis factor-alpha (TNF-α) and hepatic glucocorticoid receptor (GR) in burned mice. Methods: Forty BALB/C mice were divided randomly into 4 groups: normal control group, burned control group, fentanyl group and ketamine group. The mice in the latter three groups all received 15%～20% thickness third degree back burns. Fifteen minutes after being burned, the mice in fentanyl and ketamine group were given fentanyl injection (10ug/mg) and ketamine injection (10mg/kg), respectively. Four hours after the mice were burned, the level of serum corticosterone and TNF-α were examined and the hepatic GR level was detected by Western blot. Results: Compared with that in normal control group, the concentration of serum corticosterone and TNF-α level in burned control group increased significantly but hepatic GR level decreased. In fentanyl group, the concentration of serum corticosterone and TNF-α level were obviously lower than that in burned control group but higher than that in normal control group, and the hepatic GR level had some increases but was still lower than that in normal control group. In ketamine group, the concentration of serum corticosterone was obviously lower than that in burned control group but there was no significant differences of hepatic GR and serum TNF-α level compared with that in normal control group. Conclusion: Burn injuries in mice in the early stage can cause obvious stress and inflammatory reactions, which is proved by the obvious increase of the concentration of serum corticosterone, decrease of hepatic GR level and increase of serum TNF-α. Both fentanyl and ketamine have some inhibitory effects on them but the effects of ketamine are stronger than that of fentanyl.