异丙酚和硫喷妥钠对心肌细胞毒性作用的对比研究

Comparative cardiotoxicity of propofol and thiopental in neonatal primary myocardial cell cultures

目的 对比研究异丙酚和硫喷妥钠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5组,分别为对照组、小剂量异丙酚组(PL,3×10^(-5) mol·L^(-1))、大剂量异丙酚组(PH,3×10^(-4)mol·L^(-1))、小剂量硫喷妥钠组(TL,1×10^(-5) mol·L^(-1))和大剂量硫喷妥钠组(TH,1×10^(-4)mol·L^(-1)).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 与对照组相比,PH及TL组搏动频率明显减慢(P<0.05和P<0.01),TH组可见心肌细胞呈部分搏动或无搏动,三组细胞形态学亦有相应变化;LDH、AST与CK释放量增加(P<0.05和P<0.01),ALP活性下降.而PL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 低浓度的硫喷妥钠及高浓度的异丙酚均有直接的心肌抑制作用,高浓度的硫喷妥钠尤为明显.而低浓度异丙酚未见心肌细咆毒性作用.

Aim To investigate the cardiotoxicity of propofol and thiopental. Methods 4day-old contracting neonatal primary myocardial cells obtained from 2-to 3-day-oldWistar rats were divided into 5 groups, with normal contrast group, and the cellcultures in groups PL, PH, TL and TH, were treated with propofol(3 × 10-5 and3 × 10-4 mol· L) and thiopental (1 × 10-5 and 1 × 10-4 mol·L) for 8 h.The con-tractility and morphology of the cells were observed and the cytoplasmic enzyme(LDH, AST, CK and ALP) release content of myocardial cell and the concentrationof electrolytes (K +, Na +, Cl - and Ca2+ ) in the medium were measured 8 h afterintravenous anesthetics administration. Results In groupPH and TL decreasedsignificantly (P< 0. 05 and P< 0. 01 ) and the cells showed partly beating or nobeating in group TH. The enzemy (LDH, AST and CK) release of the cell cultures ingroup TL, TH and PH was increased (P< 0. 05 and P< 0. 01 ) and ALP decreased,associateing with in adverse effect on morphology. The results show that group PLhad little or no effect on all indices of toxicity evaluated. Electrolytes were not sig-nificantly different among all groups.Conclusion The low concentrations ofthiopental and high concentrations of propofol have significant direct myocardial de-pressant action, especially the high concentrations of thiopental, while low concen-trations of propofol has little or no effect on cardiotoxity.