曲美他嗪预先给药对异丙酚致大鼠心肌损伤的影响

Effect of trimetazidine pretreatment on myocardial injury induced by propofol in rats

目的 评价曲美他嗪预先给药对异丙酚致大鼠心肌损伤的影响.方法 健康SD大鼠40只,2.5月龄,体重240～ 250 g,采用随机数字表法,将其分为4组（n=10）：脂肪乳组（L组）静脉输注10％脂肪乳12 h,输注速率30 mg·kg-1 ·h-1;异丙酚组（P组）静脉输注1％异丙酚中/长链脂肪乳注射液12 h,输注速率30 mg·kg-·h-1;不同剂量曲美他嗪组（TL组和TH组）分别静脉注射曲美他嗪2mg/kg（TL组）和5 mg/kg（TH组）,1.5h后静脉输注异丙酚12 h,输注速率30 mg·kg-1 ·h-1.于给药开始后6、12 h时采集颈内静脉血样1.5ml检测血清肌酸激酶（CK）、肌酸激酶同工酶（CK-MB）、乳酸脱氧酶（LDH）、α-羟丁酸脱氢酶（α-HBDH）、心肌肌钙蛋白Ⅰ（cTnⅠ）、甘油三酯（TG）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）水平.给药开始后12 h采血后取心肌组织于光镜及电镜下观察心肌病理学结果.结果 与L组比较,P组和TL组血清CK、CK-MB、LDH、α-HBDH活性和cTnⅠ、TG浓度升高,HDL浓度降低（P＜0.01）,LDL浓度差异无统计学意义（P＞0.05）,TH组血清TG、HDL和LDL浓度升高（P＜0.01）,其余指标差异无统计学意义（P＞0.05）.与P组比较,TL组和TH组血清CK、CK-MB、LDH、α-HBDH活性和cTnI浓度降低,TL组血清TG浓度升高,TH组血清TG、HDL和LDL浓度升高（P＜0.01）.与TL组比较,TH组血清CK、CK-MB、LDH、α-HBDH活性和cTnI浓度降低,TG、HDL、LDL浓度升高（P＜0.01）.结论 曲美他嗪预先给药可减轻异丙酚致大鼠心肌损伤,但会引起血脂升高.

Objective To evaluate the effect of trimetazidine pretreatment on myocardial injury induced by propofol in rats.Methods Forty healthy Sprague-Dawley rats,weighing 240-250 g,aged 2.5 months,were randomly divided into 4 groups （n =10 each）：fat emulsion group （group L）,propofol group （group P）,and different doses of trimetazidine groups （TL and TH groups）.In group L,10% fat emulsion was infused intravenously for 12 h at a rate of 30 mg·kg-1 ·h-1.In group P,1% propofol was infused intravenously for 12 h at a rate of 30 mg·kg-1 ·h-1.In TL and TH groups,trimetazidine 2 and 5 mg/kg were injected intravenously,respectively,and 1.5 h later propofol was infused intravenously for 12 h at a rate of 30 mg·kg-1 ·h-1.At 6 and 12 h after beginning of administration,blood samples from the internal jugular vein were taken for determination of the levels of serum creatine kinase （CK）,creatine kinase isoenzyme-MB （CK-MB）,lactate dehydrogenase （LDH）,α-hydroxybutyric acid dehydrogenase （α-HBDH）,cardiac troponin Ⅰ （cTnⅠ）,triglycerides （TG）,low-density lipoprotein （LDL） and high-density lipoprotein （HDL）.After blood sampling at 12 h after beginning of administration,myocardial specimens were obtained for microscopic examination of the pathological changes with light and electron microscope.Results Compared with group L,the serum CK,CK-MB,LDH,α-HBDH,cTnⅠ and TG levels were significantly increased,HDL was decreased,and no significant changes were found in LDL concentrations in P and TL groups,and the serum TG,HDL and LDL were increased,and no significant changes were found in the other parameters in group TH.Compared with group P,the serum CK,CK-MB,LDH,α-HBDH,and cTnⅠ levels were significantly decreased in TL and TH groups,the serum TG level was increased in TL group,and the serum TG,HDL and LDL levels were increased in TH group.Compared with group TL,the serum CK,CK-MB,LDH,α-HBDH and cTnⅠ levels were significantly decreased,and the serum TG,HDL and LDL levels were increased in group TH.Conclusion Trimetazidine pretreatment can attenuate myocardial injury induced by propofol,but it induces increase in blood lipids.