利多卡因对兔骨骼肌缺血-再灌注损伤骨骼肌存活率及超微结构的影响

Lidocaine-pours into the damage skeletal muscle survival percentage and ultrastructure influence again to the rabbit skeletal muscle ische-mia

目的研究利多卡因全身用药对家兔骨骼肌缺血-再灌注损伤骨骼肌存活率及超微结果的影响。方法雄性新西兰兔12只,体重2.5~3kg,随机分为4组,分别记为A1、A2、B1、B2,每组3只。兔右下肢股三角区脱毛,手术显露股血管,切断股神经,无损伤血管夹阻断股动、静脉血流,右大腿中部用止血带捆扎,缺血3小时后松开血管夹和止血带,再灌注3小时。A1组和A2组兔于缺血前5分钟先经耳缘静脉分别推注利多卡因（2mg/Kg）和等体积的生理盐水,后分别持续经耳缘静脉滴注利多卡因（5ug/Kg/min）和等体积的生理盐水;B1组和B2组兔于再灌注前5分钟按照上述方法给药,在缺血0、3小时,再灌注3小时时分别取胫骨前肌、小腿三头肌,MTT法检测肌肉坏死率,取胫骨前肌透射电镜下观察不同时间的肌细胞超微结构的变化。结果与缺血前给予生理盐水组比较,缺血前给予利多卡因能够显著增加兔骨骼肌缺血3小时和再灌3小时时的存活率;与再灌注前给予生理盐水组比较,再灌注前给予利多卡因能够显著增加兔骨骼肌再灌注3小时时的存活率;缺血前给予利多卡因与再灌注前给予利多卡因均能显著增加兔骨骼肌再灌注3小时时的存活率,但是两种给药方式对骨骼肌存活率的影响无显著性差异。结论缺血前给予利多卡因能够显著改善兔的缺血和再灌注损伤,而再灌注前给予利多卡因能够显著改善兔的再灌注损伤。虽然缺血前给予利多卡因与再灌注前给予利多卡因均能改善兔的再灌注损伤,但是这两种给药放式改善骨骼肌再灌注损伤的效果无显著性差异。

Objective To investigate the effects of lidocaine on ischemia-reperfusion injury.Methods 12 healthy male New-Zealand rabbits,weighting 2.5~3Kg were randomly divided into 4 groups（n=3）,including lidocaine 2mg/Kg by ear vein injection 5 minutes before ischemia at the right lower limb,and then lidocaine 5ug/Kg/min were continuously injected for 3 hours（A1）,the same volume of saline were used as above（A2）,lidocaine 2mg/Kg by ear vein injection 5 minutes before reperfusion at the right lower limb,and then lidocaine 5ug/Kg/min were continuously injected for 3 hours（B1）,the same volume of saline were given as a group B1（B2）.The model of ischemia-reperfusion injury were formed by cutting off the right lower limb femoral nerve,blocking the artery and vein with blood vessel clip,binding right mid-thigh with the tourniquets.The tibialis anterior muscle and triceps surae muscle were selected at the beginning of the ischemia,at 3 hours of ischemia,and at 3 hours of reperfusion.The survival rate of the skeletal muscle were detected by MTT,and the ultra-structure of the skeletal muscle were observed by the transmission electron microscope.Results The survival rate of the skeletal muscle in group A1 at 3 hours of ischemia and at 3 hours of reperfusion were significantly higher than in group A2.The survival rate of the skeletal muscle in group B1 at 3 hours of reperfusion were significantly higher than in group B2.Conclusion Lidocaine can increase the survival rate of skeletal muscle both in the case of ischemia and reperfusion when given before ischemia,and were also able to improve the survival rate of skeletal muscle at 3 hours after reperfusion when administrated before reperfusion.Although the lidocaine were used before ischemia or before reperfusion can significantly improve the skeletal muscle ischemia reperfusion injury,but the 2 delivery methods had no significant differences on the survival rate of skeletal muscle.