持续输注瑞芬太尼对犬心肌缺血再灌注血清H-FABP的影响

Effect of continuous infusion of remifentanil on serum H-FABP in dogs with myocardial ischemia-reperfusion injury

目的观察术中持续输注瑞芬太尼对犬心肌缺血再灌损伤血清心型脂肪酸结合蛋白(heart-type fatty acid binding protein,H-FABP)的影响。方法将15只犬随机分为假手术组(S组)、缺血再灌注组(I/R组)和瑞芬太尼处理组(R组)。S组犬开胸后在冠状动脉左前降支下穿线不结扎;I/R组犬开胸后结扎冠状动脉左前降支,缺血30min再灌注2h;R组缺血前30min通过微量注射泵以0.5μg/(kg·min)静脉输注瑞芬太尼直到观测结束,缺血再灌注处理同I/R组。分别于缺血前、缺血30min、再灌注60min、再灌注120min时,抽取动脉血3ml,测定血清H-FABP的数值。结果在缺血30min、再灌注60min时,血清H-FABP水平R组低于I/R组(P<0.05)。再灌注120min时,三组间血清H-FABP水平没有统计学差异。结论提示术中持续输注瑞芬太尼0.5μg/(kg·min)可以通过降低血清H-FABP的表达来降低犬心肌缺血再灌注损伤。

Objective To explore the effects of continuous infusion of remifentanil on serum H-FABP in dogs with myocardial ischemiareperfusion injury . Methods Fifteen healthy dogs were divided randomly into three groups ： sham group （ S group, n = 5）, ischemiareperfusion group（ I/R group ,n = 5 ）and remifentanil group（ R group ,n = 5 ）. In S group, the dog performed thoracotomy, and then the left anterior descending coronary artery was threaded, but not ligated. After thoracotomy and the ligation of left anterior descending coronary artery,30 min ischemia and 2 h reperfusion were performed in I/R group. In R group,remifentanil was infused at the rate of 0.5 μg/（ kg · min）from the time of 30 rain before ischemia to the end of ischemia-reperfusion. Serum H-FABP was determined before ischemia,after 2 h ischemia, after 60 min and 120 min reperfusion, respectively. Results At 30min after ischemia and at 60 min after reperfusion, the serum level of H-FABP in dogs were significantly higher in R group and I/R group than in S group（ P 〈 0. 05 ）, but lower in R group than that in I/R group（P 〈0.05）. At 120 min after reperfusion,there was no significant difference in the serum level of H-FABP among 3 groups. Conclusion Continuous intraoperative infusion of remifentanil 0.5 μg/（ kg · min） can protect from myocardial ischemia-reperfusion injury by reducing the serum levels of H-FABP in dogs.