丙泊酚和氯胺酮对心肌细胞毒性作用的对比研究

COMPARISON OF THE TOXIC EFFECTS OF PROPOFOL AND KETAMINE ON MYOCARDIAL CELLS

目的 :对比研究丙泊酚和氯胺酮对心肌细胞的毒性作用。方法 :将经原代培养成活 4d后的大鼠心肌细胞分为 4组 ,分别为低浓度 (PL ,3× 10 -5mol/L)与高浓度 (PR ,3× 10 -4 mol/L)丙泊酚组和低浓度 (KL ,1× 10 -5mol/L)与高浓度 (KH ,1× 10 -4 mol/L)氯胺酮组。各组均于实验开始后 8h终止反应 ,评定心肌细胞搏动功能 ,观察细胞形态学改变 ,测定心肌细胞酶及电解质变化。结果 :组间比较 ,KL组心肌细胞搏动频率加快 (P <0 .0 5 ) ;PR和KH组搏动频率明显减慢 (P <0 .0 5 ) ,细胞形态学亦有相应变化 ;LDH ,AST与CK释放量增加 ,ALP活性下降 (P <0 .0 5 ) ;而PL和KL组的上述指标无明显变化 ;各组间电解质变化未见显著差异。结论 :PR和KH组均有直接的心肌抑制作用。而PL和KL组并无心肌细胞毒性作用 ,且KL组表现出正性变时性和变力性作用。

OBJECTIVE:To compare the toxic effects of propofol and ketamine on myocardial cells.METHOD: 4 day old spontaneously contracting neonatal primary myocardial cell cultures obtained from 2～3 day old Wister rats were divided into 4 groups and treated with 3×10 -5 mol/L propofol (PL), 3×10 -4 mol/L propofol (PR), 1×10 -5 mol/L ketamine (KL)and 1×10 -4 mol/L ketamine (KH)for 8 hours respectively.At the end of treatment, the contractility and morphology of myocardial cells and the cytoplasmic enzyme (LDH,AST,CK and ALP) released and electrolytes concentration (K +, Na +, Cl - and Ca 2+ ) in medium in each group were measured.RESULTS:The beat rate of myocardial cells was increased in KL group ( P <0.05) and significantly decreased in PR and KH groups ( P <0.05) and there was also changes in morphology. In PR and KH groups, the released enzymes of LDH, AST and CK were increased and that of ALP was decreased ( P <0.05). In KL and PL groups, there were no significant changes in parameters mentioned above. No significant change in electrolytes was observed in all groups.CONCLUSION:Ketamine and propofol in high concentration have significant direct myocardial depression effect, but in low concentration they have no toxic effect on myocardial cells, in fact, ketamine in low concentration possess positive chronotropic and inotropic effects.